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[Evidence-based medicine (EBM)] - 終
20판 Harrison 교과서의 EBM 부분 (20쪽 - 22쪽) 중 서론의 일부과 결론을 옮깁니다.
Clinical medicine is defined traditionally as a practice combining medical knowledge (including scientific evidence), intuition, and judgement in the care of patients...
... Systematic reviews should be used in conjunction with selective reading of some of the best empirical studies.
Conclusions
In this era of EBM, it is tempting to think that all the difficult decisions practitioners face have been or soon will be solved and digested into practice guidelines and computerized reminders. However, EBM provides practitioners with an ideal rather than a finished set of tools with which to manage patients. Moreover, even with such evidence, it is always worth remembering that the response to therapy of the "average" patient represented by the summary clinical trial outcomes may not be what can be expected for the specific patient sitting in front of a provider in the clinic or hospital. In addition, meta-analyses cannot generate evidence when there are no adequate randomized trials, and most of what clinicians confront in practice will never be thoroughly tested in a randomized trial. For the foreseeable future, excellent clinical reasoning skills and experience supplemented by well-designed quantitative tools and a keen appreciation for the role of individual patient preferences in their health care will continue to be of paramount importance in the practice of clinical medicine.
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