Evidence-based medicine;
Care of whole persons;
USERS GUIDES;
CLINICAL-DIAGNOSIS;
ARTICLE;
DISEASE;
D O I:
10.1016/j.jclinepi.2017.02.002
中图分类号:
R19 [保健组织与事业(卫生事业管理)];
学科分类号:
摘要:
In this issue of the Journal, Dr. Fava posits that evidence-based medicine (EBM) was bound to fail. I share some of the concerns he expresses, yet I see more reasons for optimism. Having been on rounds with both Drs. Engel and Sackett, I reckon they would have agreed more than they disagreed. Their central teaching was the compassionate and well-informed care of sick persons. The model that emerged from these rounds was that patient care could be both person-centered and evidence-based, that clinical judgment was essential to both, and the decisions could and should be shared. Both clinicians and patients can bring knowledge from several sources into the shared decision making process in the clinical encounter, including evidence from clinical care research. I thank Dr. Fava for expressing legitimate doubts and providing useful criticism, yet I am cautiously optimistic that the model of EBM described here is robust enough to meet the challenges and is not doomed to fail. (C) 2017 Elsevier Inc. All rights reserved.
机构:
Temple Univ, Temple Transformat Med Inst, Dept Med, 3500 N Broad St, Philadelphia, PA 19140 USATemple Univ, Temple Transformat Med Inst, Dept Med, 3500 N Broad St, Philadelphia, PA 19140 USA
Horwitz, Ralph I.
Singer, Burton H.
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机构:
Univ Florida, Emerging Pathogens Inst, POB 100009, Gainesville, FL 32610 USATemple Univ, Temple Transformat Med Inst, Dept Med, 3500 N Broad St, Philadelphia, PA 19140 USA
机构:
Jordan Univ Sci & Technol, Fac Med, Dept Community Med Publ Hlth & Family Med, Irbid 22110, JordanJordan Univ Sci & Technol, Fac Med, Dept Community Med Publ Hlth & Family Med, Irbid 22110, Jordan
Al Omari, Mousa
Khader, Yousef
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机构:
Jordan Univ Sci & Technol, Fac Med, Dept Community Med Publ Hlth & Family Med, Irbid 22110, JordanJordan Univ Sci & Technol, Fac Med, Dept Community Med Publ Hlth & Family Med, Irbid 22110, Jordan
Khader, Yousef
Jadallah, Khaled
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机构:
Jordan Univ Sci & Technol, Fac Med, Dept Internal Med, Irbid 22110, Jordan
King Abdullah Univ Hosp, Irbid, JordanJordan Univ Sci & Technol, Fac Med, Dept Community Med Publ Hlth & Family Med, Irbid 22110, Jordan
Jadallah, Khaled
Dauod, Ali Shakir
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机构:
Univ Mosul, Fac Med, Dept Community Med Publ Hlth & Family Med, Mosul, IraqJordan Univ Sci & Technol, Fac Med, Dept Community Med Publ Hlth & Family Med, Irbid 22110, Jordan
Dauod, Ali Shakir
Al-shdifat, Amjad Ali Khalaf
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机构:
Jordan Univ Sci & Technol, Fac Med, Dept Community Med Publ Hlth & Family Med, Irbid 22110, JordanJordan Univ Sci & Technol, Fac Med, Dept Community Med Publ Hlth & Family Med, Irbid 22110, Jordan