临床循证实践面临的困难与对策

Difficulties and Improvement Strategies of Achieving Evidence-based Practice

近20年来,循证医学获得长足进展,然而临床循证实践与循证医学两者之间还存在巨大的鸿沟,医师临床循证实践的开展情况仍受到各种因素的制约。文章从科学证据、医护人员、患者、组织和卫生系统等五个方面对科学证据转化为循证实践面临的困难进行了系统回顾,并从循证临床实践指南开发、医学教育、信息化建设、医疗机构管理和加强卫生系统的作用等角度提出了促进循证实践开展的建议。

During the last 20 years, evidence-based medicine has made great progress. But there is a great gap between evidence-based practice and evidence-based medicine. The development of evidence-based practice is affected by many factors. The barriers to achieving evidence-based practice from evidences, health professionals, patients, or- ganizations and health system perspectives are reviewed systematically. The suggestions of improvement strategies were put forward through evidence-based clinical practice guideline development, medical education, informatization construction, health institution management and health system.