Evidence-based medicine is widely promoted for decision-making in health care and is associated with improved patient outcomes.Critics have suggested that evidence-based medicine focuses primarily on groups of patient...Evidence-based medicine is widely promoted for decision-making in health care and is associated with improved patient outcomes.Critics have suggested that evidence-based medicine focuses primarily on groups of patients rather than individuals,but often fail to consider subgroup analyses,N-of-1 trials,and the incorporation of patient values and preferences.Precision medicine has been promoted as an approach to individualize diagnosis and treatment of diseases through genetic,biomarker,phenotypic,and psychosocial characteristics.However,there are often high costs associated with personalized medicine,and high-quality evidence is lacking for effectiveness in many applications.For the potential of personalized medicine to be realized,it must adhere to the principles of evidencebased medicine:(1)evidence in isolation is not sufficient to make clinical decisions—patient’s values and preferences as well as resource implications must be considered,and(2)there is a hierarchy of evidence to guide clinical decision-making and studies at lower risk of bias are likely to provide more trustworthy findings.展开更多
文摘研究装备质量评估中指标优化、权重确定、评估方法选取等问题.首先运用改进的群层次分析法(IGAHP)选取通用特性指标、测试数据指标作为状态评估的二级指标;在对质量状态进行定性划分的基础上,分别采用IGAHP、CRITIC(criteria improved through inter-criteria correlation)等方法对状态评估三级指标进行遴选和权重分析;然后,提出改进证据推理(ER)方法进行通用特性指标的评估,并采用CRITIC方法,基于客观权重进行测试指标降维优化,对各评估结果进行改进ER融合;最后通过算例验证所提出方法的有效性和优越性.研究结果表明:IGAHP-CRITIC组合赋权方法可有效综合主客观权重信息;通过指标优化可降低评估的维数和复杂度;考虑证据冲突的改进ER方法可有效降低评估的不确定性和不完备性.
文摘Evidence-based medicine is widely promoted for decision-making in health care and is associated with improved patient outcomes.Critics have suggested that evidence-based medicine focuses primarily on groups of patients rather than individuals,but often fail to consider subgroup analyses,N-of-1 trials,and the incorporation of patient values and preferences.Precision medicine has been promoted as an approach to individualize diagnosis and treatment of diseases through genetic,biomarker,phenotypic,and psychosocial characteristics.However,there are often high costs associated with personalized medicine,and high-quality evidence is lacking for effectiveness in many applications.For the potential of personalized medicine to be realized,it must adhere to the principles of evidencebased medicine:(1)evidence in isolation is not sufficient to make clinical decisions—patient’s values and preferences as well as resource implications must be considered,and(2)there is a hierarchy of evidence to guide clinical decision-making and studies at lower risk of bias are likely to provide more trustworthy findings.
