协和医学杂志

2019, v.10(04) 398-402

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临床流行病学和循证医学的学科建设
Discipline Construction of Clinical Epidemiology and Evidence-based Medicine:What,Who,Where,and Whither?

刘晓清;吴东;
LIU Xiao-qing;WU Dong;Department of Infectious Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Unit of Teaching and Research of Clinical Epidemiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Clinical Epidemiology Unit,International Clinical Epidemiology Network;Department of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & P

摘要(Abstract):

临床流行病学是在临床医学领域内引入现代流行病学和统计学方法,从患病个体诊治扩大到患病群体研究,以探讨疾病病因、预防、诊断、治疗、预后等规律的临床基础学科。循证医学的核心思想是通过检索、评价和应用证据,结合医生技术经验和患者的具体情况,经医患共同决策作出符合患者需求的利大于弊的诊疗决定。加拿大McMaster大学的David Sackett及其学生Gorden Guyatt先后对临床流行病学这门学科的建立、完善和传播,对循证医学概念的提出、发展和推动,起到了里程碑式的作用。20世纪80年代初,我国第一批追随David Sackett的医生方法学家引入了临床流行病学的核心思想,即临床研究的设计、测量和评价,90年代又引入了循证医学的理念。30年来,临床流行病学和循证医学在我国生根、发芽、开花、结果,对我国现代医学的发展起到了巨大推动作用。在全面建设"健康中国"的新时代,加强临床流行病学和循证医学的学科建设刻不容缓。
Clinical Epidemiology( CE) is an essential course of medicine that involves the application of methods established by Modern Epidemiology and Statistics to investigate the etiology,prophylaxis,diagnosis,treatment,and prognosis of diseases-inflicted subjects from individuals to populations. Evidence-Based Medicine( EBM) requires healthcare providers to make shared-decisions for the patient's best interest through extensively searching,explicitly appraising,and judiciously applying evidence in the light of the physician's expertise and the patient's values and preferences. David Sackett,who is from McMaster University,and his successor,Gordon Guyatt,have become the iconic figures of founding,improving and spreading CE/EBM globally.In 1980 s David Sackett tutored the first generation of physician-methodologists from China,and they,in turn,introduced the core concepts of CE,i. e.,the design,measurement and evaluation of clinical research,into their own homeland. Thanks to their effort,China embraced EBM in parallel with the world in the 1990 s. Over the past three decades,we have witnessed the infancy,childhood,adolescence,and mature adulthood of CE and EBM in China and have benefited tremendously from therein. Today,the task to strengthen CE and EBM in China becomes even imminent in the era of building Healthy China.

关键词(KeyWords): 临床流行病学;循证医学;临床决策;医学教育
clinical epidemiology;evidence-based medicine;clinical decision-making;medical education

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基金项目(Foundation): 北京协和医学院教育教学改革立项项目(2013zlgc0115);北京协和医学院研究生教育教学改革项目(10023201600109)

作者(Author): 刘晓清;吴东;
LIU Xiao-qing;WU Dong;Department of Infectious Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Unit of Teaching and Research of Clinical Epidemiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Clinical Epidemiology Unit,International Clinical Epidemiology Network;Department of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & P

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