知證衛生決策工具之一——什么是知證決策*_《中國循證醫學雜志》

作者：

Andrew D Oxman ¹ , John N Lavis ² , Simon Lewin ³ , Atle Fretheim ⁴

關鍵詞：

DOI：

10.7507/1672-2531.20100393

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本文討論以下3 個問題：① 什么是證據？② 研究證據在知證衛生決策中有何作用？③ 什么是知證決策？知證衛生決策是一種決策方法，旨在保證基于最佳可及的研究證據做出決策。知證決策的特點是將系統、透明地獲取和評價證據的方法引入決策全過程。雖不要求制定政策的整個過程系統和透明，但在制定政策的全過程，采用系統的步驟可以確保合理地查找、評價和使用相關研究。過程透明化旨在確保他人可以檢查什么樣的研究證據被用于支持決策并評價證據及其意義。知證決策幫助政策制定者了解這些過程。

引用本文： Andrew D Oxman,John N Lavis,Simon Lewin,Atle Fretheim. 知證衛生決策工具之一——什么是知證決策*. 中國循證醫學雜志, 2010, 10(3): 240-246. doi: 10.7507/1672-2531.20100393 復制

1.	Lavis JN, Oxman AD, Lewin S, et al. SUPPORT Tools for evidenceinformed health Policymaking (STP). Introduction. Health Res Policy Syst, 2009, 7(Suppl 1): I1.
2.	Lavis JN, Wilson MG, Oxman AD, et al. SUPPORT Tools for evidence-informed health policymaking (STP). 4. Using research evidence to clarify a problem. Res Policy Syst Health Res Policy Syst, 2009, 7(Suppl 1): S4.
3.	Task Force on Health Systems Research: Informed choices for attaining the millennium development goals: towards an international cooperative agenda for health systems research. Lancet, 2004, 364: 997-1003.
4.	Chalmers I. If evidence-informed policy works in practice, does it matter if it doesn’t work in theory? Evidence & Policy, 2005, 1(2): 227-2242.
5.	Oxman AD, Lavis JN, Fretheim A. The use of evidence in WHO recommendations. Lancet, 2007, 369: 1883-1889.
6.	Lavis JN, Davies HTO, Oxman A, et al. Towards systematic reviews that inform healthcare management and policymaking. J Health Serv Res Policy, 2005, 10: 35-48.
7.	Innvaer S, Vist G, Trommald M, et al. Health policy-makers’ perceptions of their use of evidence: a systematic review. J Health Serv Res Policy, 2002, 7: 239-244.
8.	Lavis JN, Ross SE, Hurley JE, et al. Examining the role of health services research in public policymaking. Milbank Quarterly, 2002, 80: 125-154.
9.	United Nations: The Millennium Development Goals Report. [http://mdgs.un.org/unsd/mdg/Resources/Static/Products/Progress2007/ UNSD_MDG_Report_2007e.pd] webcite United Nations; 2007.
10.	United Nations Development Programme: Human Development Report 2006. [http://hdr.undp.org/hdr2006/statistics/data] webcite United Nations Development Programme; 2006.
11.	Victora CG, Wagstaff A, Schellenberg JA, et al. Applying an equity lens to child health and mortality: more of the same is not enough. Lancet, 2003, 362: 233-241.
12.	Sevene E, Lewin S, Marino A, et al. Can a drug be too cheap? The unavailability of magnesium sulphate for the treatment of eclampsia and preeclampsia in Mozambique and Zimbabwe: systems and market failures. BMJ, 2005, 331: 765.
13.	Lavis JN, Posada FB, Haines A, et al. Use of research to inform public policymaking. Lancet, 2004, 364: 1615-1621.
14.	Guyatt G, Rennie D, Meade MO, et al. Users’ Guides to the Medical Literature. A Manual for Evidence-Based Clinical Practice. Second edition. McGraw Hill; 2008.
15.	Lomas J, Culver T, McCutcheon C, et al. Conceptualizing and Combining evidence for health system guidance. [http://www.chsrf. ca/other_documents/evidence_e.php] webcite Canadian Health Services Research Foundation; 2005.
16.	Schuneman HJ, Fretheim A, Oxman A. Improving the Use of Research Evidence in Guideline Development: 9. Grading evidence and recommendations. Health Res Policy Syst, 2006, 4: 12.
17.	Counsell CE, Clarke MJ, Slattery J, et al. The miracle of DICE therapy for acute stroke: fact or fictional product of subgroup analysis? BMJ, 1994, 309: 1677-1681.
18.	Guyatt G, Wyer P, Ioannidis J. When to believe a subgroup analysis. In Users’ Guide to the Medical Literature. A Manual for Evidence- Based Clinical Practice. Edited by: Guyatt G, Rennie D, Meade MO, Cook DJ. New York: McGraw Hill; 2008: 571-593.
19.	Oxman AD, Fretheim A, Schuneman HJ. Improving the Use of Research Evidence in Guideline Development: 7. Deciding what evidence to include. Health Res Policy Syst, 2006, 4: 19.
20.	Evidence-Based Medicine Working Group. Evidence-based medicine. A new approach to teaching the practice of medicine. JAMA,1992, 268: 2420-2425.
21.	Oxman AD, Sacket DL, Guyatt G, for the Evidence-Based Medicine Working Group: Users’ guides to the medical literature, I. How to get started. JAMA, 1993, 270: 2093-2095.
22.	Packwood A. Evidence-based policy: rhetoric and reality. Social Policy and Society, 2002, 1(3): 267-272.
23.	Straus SE, McAlister FA. Evidence-based medicine: a commentary on common criticisms. CMAJ, 2000, 163: 837-841.
24.	Clarence E. Technocracy reinvented: the new evidence based policy movement. Public Policy and Administration, 2002, 17: 1-11.
25.	Parsons W. From muddling through to muddling up – evidence based policy making and the modernisation of British Government. Public Policy and Administration,2002, 17: 43-60.
26.	Nutley S. Bridging the policy/research divide: reflections and lessons from the UK. [http://www.treasury.govt.nz/publications/mediaspeeches/ guestlectures/pdfs/tgls-nutley.pdf] webcite St. Andrews: University of St. Andrews; 2003.
27.	World Health Organization: World report on knowledge for better health. [http://www.who.int/rpc/wr2004] webcite World Health Organisation, 2004.
28.	World Health Organization. The Mexico statement on health research. [http://www.who.int/rpc/summit/agenda/Mexico_Statement- English.pdf] webcite World Health Organization; 2004.
29.	World Health Assembly. Resolution on health research. [http:// www.who.int/rpc/meetings/58th_WHA_resolution.pdf] webcite World Health Organization, 2005.
30.	World Health Organization. The Bamako call to action on research for health. [http://www.who.int/gb/ebwha/pdf_files/EB124/ B124_12Add2-en.pdf] webcite World Health Organization; 2008.
31.	Duley L, Henderson-Smart D. Magnesium sulphate versus diazepam for eclampsia. Cochrane Database Syst Rev, 2003, 4: CD000127.
32.	Duley L, Gulmezoglu AM, Henderson-Smart DJ. Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev, 2003, 2: CD000025.
33.	Langer A, Villar J, Tell K, et al. Reducing eclampsia-related deaths——a call to action. Lancet, 2008, 371: 705-706.

1. Lavis JN, Oxman AD, Lewin S, et al. SUPPORT Tools for evidenceinformed health Policymaking (STP). Introduction. Health Res Policy Syst, 2009, 7(Suppl 1): I1.
2. Lavis JN, Wilson MG, Oxman AD, et al. SUPPORT Tools for evidence-informed health policymaking (STP). 4. Using research evidence to clarify a problem. Res Policy Syst Health Res Policy Syst, 2009, 7(Suppl 1): S4.
3. Task Force on Health Systems Research: Informed choices for attaining the millennium development goals: towards an international cooperative agenda for health systems research. Lancet, 2004, 364: 997-1003.
4. Chalmers I. If evidence-informed policy works in practice, does it matter if it doesn’t work in theory? Evidence & Policy, 2005, 1(2): 227-2242.
5. Oxman AD, Lavis JN, Fretheim A. The use of evidence in WHO recommendations. Lancet, 2007, 369: 1883-1889.
6. Lavis JN, Davies HTO, Oxman A, et al. Towards systematic reviews that inform healthcare management and policymaking. J Health Serv Res Policy, 2005, 10: 35-48.
7. Innvaer S, Vist G, Trommald M, et al. Health policy-makers’ perceptions of their use of evidence: a systematic review. J Health Serv Res Policy, 2002, 7: 239-244.
8. Lavis JN, Ross SE, Hurley JE, et al. Examining the role of health services research in public policymaking. Milbank Quarterly, 2002, 80: 125-154.
9. United Nations: The Millennium Development Goals Report. [http://mdgs.un.org/unsd/mdg/Resources/Static/Products/Progress2007/ UNSD_MDG_Report_2007e.pd] webcite United Nations; 2007.
10. United Nations Development Programme: Human Development Report 2006. [http://hdr.undp.org/hdr2006/statistics/data] webcite United Nations Development Programme; 2006.
11. Victora CG, Wagstaff A, Schellenberg JA, et al. Applying an equity lens to child health and mortality: more of the same is not enough. Lancet, 2003, 362: 233-241.
12. Sevene E, Lewin S, Marino A, et al. Can a drug be too cheap? The unavailability of magnesium sulphate for the treatment of eclampsia and preeclampsia in Mozambique and Zimbabwe: systems and market failures. BMJ, 2005, 331: 765.
13. Lavis JN, Posada FB, Haines A, et al. Use of research to inform public policymaking. Lancet, 2004, 364: 1615-1621.
14. Guyatt G, Rennie D, Meade MO, et al. Users’ Guides to the Medical Literature. A Manual for Evidence-Based Clinical Practice. Second edition. McGraw Hill; 2008.
15. Lomas J, Culver T, McCutcheon C, et al. Conceptualizing and Combining evidence for health system guidance. [http://www.chsrf. ca/other_documents/evidence_e.php] webcite Canadian Health Services Research Foundation; 2005.
16. Schuneman HJ, Fretheim A, Oxman A. Improving the Use of Research Evidence in Guideline Development: 9. Grading evidence and recommendations. Health Res Policy Syst, 2006, 4: 12.
17. Counsell CE, Clarke MJ, Slattery J, et al. The miracle of DICE therapy for acute stroke: fact or fictional product of subgroup analysis? BMJ, 1994, 309: 1677-1681.
18. Guyatt G, Wyer P, Ioannidis J. When to believe a subgroup analysis. In Users’ Guide to the Medical Literature. A Manual for Evidence- Based Clinical Practice. Edited by: Guyatt G, Rennie D, Meade MO, Cook DJ. New York: McGraw Hill; 2008: 571-593.
19. Oxman AD, Fretheim A, Schuneman HJ. Improving the Use of Research Evidence in Guideline Development: 7. Deciding what evidence to include. Health Res Policy Syst, 2006, 4: 19.
20. Evidence-Based Medicine Working Group. Evidence-based medicine. A new approach to teaching the practice of medicine. JAMA,1992, 268: 2420-2425.
21. Oxman AD, Sacket DL, Guyatt G, for the Evidence-Based Medicine Working Group: Users’ guides to the medical literature, I. How to get started. JAMA, 1993, 270: 2093-2095.
22. Packwood A. Evidence-based policy: rhetoric and reality. Social Policy and Society, 2002, 1(3): 267-272.
23. Straus SE, McAlister FA. Evidence-based medicine: a commentary on common criticisms. CMAJ, 2000, 163: 837-841.
24. Clarence E. Technocracy reinvented: the new evidence based policy movement. Public Policy and Administration, 2002, 17: 1-11.
25. Parsons W. From muddling through to muddling up – evidence based policy making and the modernisation of British Government. Public Policy and Administration,2002, 17: 43-60.
26. Nutley S. Bridging the policy/research divide: reflections and lessons from the UK. [http://www.treasury.govt.nz/publications/mediaspeeches/ guestlectures/pdfs/tgls-nutley.pdf] webcite St. Andrews: University of St. Andrews; 2003.
27. World Health Organization: World report on knowledge for better health. [http://www.who.int/rpc/wr2004] webcite World Health Organisation, 2004.
28. World Health Organization. The Mexico statement on health research. [http://www.who.int/rpc/summit/agenda/Mexico_Statement- English.pdf] webcite World Health Organization; 2004.
29. World Health Assembly. Resolution on health research. [http:// www.who.int/rpc/meetings/58th_WHA_resolution.pdf] webcite World Health Organization, 2005.
30. World Health Organization. The Bamako call to action on research for health. [http://www.who.int/gb/ebwha/pdf_files/EB124/ B124_12Add2-en.pdf] webcite World Health Organization; 2008.
31. Duley L, Henderson-Smart D. Magnesium sulphate versus diazepam for eclampsia. Cochrane Database Syst Rev, 2003, 4: CD000127.
32. Duley L, Gulmezoglu AM, Henderson-Smart DJ. Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev, 2003, 2: CD000025.
33. Langer A, Villar J, Tell K, et al. Reducing eclampsia-related deaths——a call to action. Lancet, 2008, 371: 705-706.

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知證衛生決策工具之一——什么是知證決策*

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《中國循證醫學雜志》

知證衛生決策工具之一——什么是知證決策*

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