■高质量的医疗保健决策需要平衡科学和临床实践的投入。当两个证据来源——如科学证据和实践证据——进行比较时,集成,或者需要互相代替,它们需要在相似的尺寸上具有可比性。自1891年以来,瑞典医生一直根据法律要求进行医疗决策,以科学和“经验证明”(大约是临床专业知识)为基础。今天,瑞典的所有医疗保健人员都属于这一法律要求。
■我们研究了这两种证据在重要性方面的动态关系,系统性,通过研究瑞典医疗保健专业人员和确定性。
■对专业人士的调查;政治话语的文献研究。
■在这项研究中,对瑞典医学专业人员的简单随机样本进行了调查,护理,职业治疗,牙科,和牙齿卫生,询问科学在医学决策中的作用和成熟的经验。结果措施是多么重要,Certain,和系统的科学和成熟的经验是成功的医疗决策。
■抽样框架是瑞典联邦统计机构访问的每个行业的最新职业注册表。共分发了3500份调查。返回了1626项调查。26名参与者在分析前被移除(排除标准:指定一个以上的职业,缺少证书,和阶层错误)。最终样本由295名医生组成,300名护士,365职业治疗师,339名牙医,和301名卫生员。在分析中用作变量的问题中,有162个回答是不可解释的或空的;这些回答被替换为给定参与者职业对给定问题的模态响应。
■在研究中,证明经验对临床决策的感知重要性与其确定性和系统性正相关,在这项研究中调查的几乎所有职业中,确定性和系统性的增加与科学和成熟经验之间重要性差异的减少正相关。
■经验证明在临床决策中具有证据作用,这个角色部分取决于它的确定性和系统性。值得注意的是,这使得基于EBM的观点认为实践派生知识主要具有实施价值的观点不那么合理。
UNASSIGNED: High-quality healthcare decisions need to balance input from science and clinical practice. When two sources of evidence - such as scientific and practice-derived evidence - are compared, integrated, or need to stand-in for one another, they need to be comparable on similar dimensions. Since 1891, Swedish physicians have been operating under a legal requirement to base their healthcare decisions on science and \"proven experience\" (approximately clinical expertise), and today all healthcare personnel in Sweden fall under this legal requirement.
UNASSIGNED: We investigated the dynamics between these two kinds of evidence with respect to importance, systematicity, and certainty by studying Swedish healthcare professionals.
UNASSIGNED: Survey to professionals; document studies of political discourse.
UNASSIGNED: In this study, a survey was sent to simple random samples of Swedish professionals in medicine, nursing, occupational therapy, dentistry, and dental hygiene, asking about the roles of science and proven experience in medical decision making. Outcome measures were how important, certain, and systematic science and proven experience are for successful medical decision making.
UNASSIGNED: The sampling frame was each profession\'s most recent occupational registry accessed by the Swedish federal statistical agency. 3500 surveys were distributed. 1626 surveys were returned. 26 participants were removed prior to analysis (exclusion criteria: more than one profession indicated, missing certificate, and mistake in stratum). The final sample consisted of 295 physicians, 300 nurses, 365 occupational therapists, 339 dentists, and 301 hygienists. 162 responses in questions used as variables in the analyses were either uninterpretable or empty; those were replaced with the modal response for a given participant\'s profession on a given question.
UNASSIGNED: In the study, proven experience\'s perceived importance for clinical decision making is positively correlated with its certainty and systematicity, and an increased certainty and systematicity is positively correlated with a diminished difference in importance between science and proven experience for almost all professions surveyed in this study.
UNASSIGNED: Proven experience has an evidentiary role in clinical decision making, and this role depends in part on its certainty and systematicity. Notably, this makes the EBM-based perspective that practice-derived knowledge is primarily of implementation value less plausible.