实症医疗照护决策.ppt

實證醫學之嚴格評讀 嘉義基督教醫院 整形外科 李孝貞 2010.11.18 醫學資料庫的種類 Secondary sources（證據評鑑資料庫） Cochrane database of systematic reviews Best Evidence, ACPJC, EBM Review, Bandolier (article review) Clinical Evidence (EB guideline or EB textbook) uptodate, MD consult Primary sources （原始文獻資料庫） 中華民國期刊論文, Medline, PubMed, CINAHL, …. 教科書, 網路電子書 The Evidence Pyramid Hierarchy of studies Read the “key” Levels of Recommendation (USPSTF) A – Highest – Strongly recommended (PAP smears) B – Recommended (Mammograms age 40+) C – no recommendation for or against (too close a balance between harm/benefit) (osteoporosis scree