Evidence-based medicine emphasizes that treatment must be based on the following elements ： the latest and best evidence, clinicians＇ expertise and patients＇ preference. Evidence-based medicine embodies the ethos both to explore medical science and to respect patients＇ values. Evidence-based medicine is an integration of the scientific and the humanistic spirit.
Gordon Henry Guyatt(1953-)is a professor of Department of Clinical Epidemiology amp; Biostatistics and Department of Medicine in McMaster University. He has engaged in evidence-based clinical research and practice for about 20 years. In 1992, he first proposed the term “evidence-based medicine” in one of his articles published in JAMA. He is dedicated to bringing the wonderful idea of evidence-based medicine to bedside and systematically training clinicians from all over the world to acquire the basic skills for evidence-based clinical practice. His great contribution to evidence-based medicine is introduced in this article through demonstrating the development of evidence-based clinical practice.
Gout is caused by abnormal metabolism of purine. Its most common symptom attack of intense pain and swelling in the joints. Attacks of gout can according to the alteration if it is in acute interval periods. How can we get the optimal effect? The development of methodology has provided much convincing evidence for us to choose the most appropriate treatment.
General practice is a new discipline, and it is in common with evidence-based medicine for the features of “patient-centered” and “evidence-based”. Evidence-based medicine has spread in all fields of clinical practice, and it has been applied to different extents in many medical health and medical education fields including general practice. This paper aims to discuss and analyze the significance, modes and attentions of evidence-based general practice, so as to provide further references for promoting the practice of evidence-based general practice in China.
To analyze the current doctor-patient relationship and explore its underlying reasons. Evidence-based medicine may provide scientific evidence for the deepening of healthcare reforms as well as the improvement of social security system; provide abundant information for both sides of the doctor-patient relationship; improve medical quality and reduce medical costs, so as to establish a harmonious patient-oriented doctor-patient relationship .
Literature bias, which can reduce the validity of a systematic review, comes mainly from the fact that all the related studies can not be collected without exception. The following three types of literature bias are most common. (1) Publication bias. The reason is that some studies can not get published, or the publication has been delayed. (2) Literature retrieval bias. This bias is the result that not all published studies are retrieved during the course of systematic review. (3) Literature inclusion bias. While an improper literature selection strategy is adopted, some useful studies are kicked out by error, leading to such bias. A funnel plot (Y-axis is rumple size, X-axis effect) is usually useful to assess literature bias in a systematic review.
Evidencebased medicine (EBM) is different fromtraditional medicine in that the practice of EBM comes from evidence and experience of the doctors. The objective evidence plays a key role in clinical practice. During the clinical teaching process, the following steps should be taken: firstly, the students should find a problem in their clinical practice; then, theyshould search for the evidence with the help of their teachers, evaluate the evidence, apply the evidence to the clinical practice, and solve the problem; finally, they should evaluate the effectiveness. An introduction of the principles and methods of EBM to the clinical practice can greatly improve the students’ ability to analyze and solve a clinical problem.