循证医学证据体系在儿科临床教学中的应用

Application of Evidence-based Medicine Evidence System in Pediatric Clinical Teaching

探讨如何在儿科临床教学中培养儿科医师运用循证医学证据的能力。"5S"循证证据体系即研究(studies),综述(syntheses),摘要(synopses),总结(summaries)和系统(systems),概括了循证医学证据来源;GRADE标准是证据质量分级和推荐强度标准;循证临床决策模式是将医生的临床经验、当前最佳的研究证据、患者的意愿三者有机结合进行临床决策。在日常临床教学中通过具体案例构建一个临床问题,围绕该临床问题,利用"5S"证据模型获得该问题的当前最佳证据,并通过GRADE标准进行证据级别评价,最后通过三位一体的循证决策模式来进行临床决策来解决临床问题。这样反复的循证实践过程能够加强儿科医师循证方法及思维的培养。

To explore how to cultivate pediatricians' ability to use evidence-based medicine in pediatric clinical teaching."5S" evidence-based evidence system is to studies,syntheses,synopses,summaries and systems, which summarize the source of evidence in evidence-based medicine. GRADE standard is the standard of evidence quality classification and recommended strength.Evidence-based clinical decision-making model is an organic combination of doctors' clinical experience,the best current research evidence and the wishes of patients to make clinical decisions.In the daily clinical teaching,a clinical problem is constructed through a specific case.Around the clinical problem,the current best evidence of the problem is obtained by using the "5S" evidence model, and the evidence level is evaluated by GRADE standard.Finally,we make clinical decisions through the trinity of evidence-based decisionmaking model to solve clinical problems.This repeated evidence-based practice process can strengthen the pediatrician evidence-based methods and thinking training.