在临床试验中寻找和应用证据:"证据车"
1Nuffield Department of Clinical Medicine, University of Oxford, England. sackett@cebm.jr2.ox.ac.uk
JAMA
|October 30, 1998
概括
证据车在医院巡回期间改善了对临床证据的访问,增加了其在患者护理决策中的使用. 该工具促进了基于证据的实践,确认或更改诊断和治疗计划.
科学领域:
- 医疗信息学 医疗信息学
- 临床决策支持 临床决策支持
- 基于证据的医学基于证据的医学.
背景情况:
- 医生需要立即获得证据,以便在患者护理期间做出临床决策.
- 之前的研究并没有评估房屋工作人员巡回调查期间使用证据的情况.
研究的目的:
- 评估在临床试验中使用专门的"证据车"访问和应用证据的可行性.
- 购物车集成了多个证据来源,具有投影和打印功能.
主要方法:
- 一个描述性可行性研究是在一个月内对通用医学住院服务进行的.
- 这项研究涉及医学学生,家庭工作人员,研究员和咨询顾问.
- 使用了一个包含各种资源的证据车 (例如,批判性评估主题,科克莱恩图书馆,MEDLINE).
主要成果:
- 证据车被使用了98次;然而,它的批量限制了床边使用,需要纸质副本.
- 在团队和学生轮期间,搜索是实用的 (10.2-25.4秒).
- 81%的搜索旨在为诊断/治疗决策提供信息,成功率为90%.
- 成功的搜索证实了现有计划 (52%),建议了新的行动 (25%),或纠正了以前的方法 (23%).
- 当车子被移除时,对证据的需求增加了,但搜索只发生了12%的时间.
结论:
- 在繁忙的住院医疗服务中实施证据车,提高了患者护理中证据的检索和应用.
- 快速获取证据支持基于证据的实践,并改善临床决策.
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