| 근거중심의학에 있어서의 근거는 무엇인가 ? |
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이창현 |
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제주대학교 의과대학 외과학교실 |
| Evidence in Evidence Based Medicine : What Is It, Where Do We Find It, and How Do We Use It ? |
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Chang-Hyun Lee |
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Department of Surgery, College of Medicine, Cheju National University, Jeju 690-756, Korea |
Correspondence:
Chang-Hyun Lee, Email: chlee@cheju.ac.kr
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| Abstract |
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The purpose of this paper is to review the history and rationale for evidence based medicine (EBM). EBM was developed because of the awareness of the limitations of traditional determinants. The development of EBM is briefly described, together with the pros and cons of evidence based research, review techniques and resources. In short, EBM can be defined as the conscientious, explicit and judicious use of current best evidence to make decisions about the care of individual patients. The four main steps in EBM practice are: (1) fomulate a clear question from a patients problem, (2) search the literature for relevant clinical articles, (3) evaluate and critically appraise existing evidence for its validity and usefulness, and (4) implement useful findings in clinical practice.
The concept, use and definition of "evidence" has evolved significantly during recent years. The power of the evidence based approach can be enhanced by the development of techniques such as systemic review and meta-analysis. However, although EBM allows us to use current best evidence to make decisions about patient care, the evidence gained from systemic review and meta-analysis only applies to an "average patient" and is not ready adaptable to issues such as etiology, diagnosis and prognosis.
The EBM with problem based learning allows students to integrate knowledge, skills and attitudes acquired elsewhere during medical education while providing an opportunity to introduce critical topics important to the care of patients. There is a trend toward providing a formal curriculum. |
| Key Words:
Evidence, Evidence Based Medicine (EBM) |
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