PERILS OF EVIDENCE-BASED MEDICINE

被引：40

作者：

Williams, Ben A. ^{[1
]}

机构：

[1] Univ Calif San Diego, Dept Psychol, La Jolla, CA 92093 USA

来源：

PERSPECTIVES IN BIOLOGY AND MEDICINE | 2010年 / 53卷 / 01期

关键词：

RECURSIVE PARTITIONING ANALYSIS; RADIATION-THERAPY; PROGNOSTIC-FACTORS; RANDOMIZED-TRIAL; GLIOMA PATIENTS; PHASE-II; RADIOTHERAPY; TEMOZOLOMIDE; PROCARBAZINE; MORTALITY;

D O I：

10.1353/pbm.0.0132

中图分类号：

N09 [自然科学史]; B [哲学、宗教];

学科分类号：

01 ; 0101 ; 010108 ; 060207 ; 060305 ; 0712 ;

摘要：

Evidenced-based medicine views random-assignment clinical trials as the gold standard of evidence. Because patient populations are heterogeneous, large numbers of patients must be studied in order to achieve statistically significant results, but the means or medians of these large samples have weak predictive validity for individual patients. Further, the logic of random-assignment clinical trials allows only the inference that some subset of patients benefits from the treatment. Post-hoc analysis is therefore necessary to identify those patients. Otherwise, many patients may receive treatments that are useless and potentially harmful.

引用

页码：106 / 120

页数：15

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