Проверка медицины

Большинство людей удивится, если они узнают о том, что строгое использование формальных правил доказательств для оценки медицинских исследований и выбора самого эффективного лечения – это недавнее явление. Возможно, они бы также удивились, если бы узнали о том, что политика в области здравоохранения все еще не подчиняется этому подходу.

Так называемая “медицина на основе доказательств” влечет за собой иерархию практических подтверждений, которые оценивают медицинские исследования согласно их качеству. Физиологические исследования, проводимые на животных, или исследования человеческих реакций в лабораторных условиях, находятся внизу иерархии. Исследования по данным наблюдений, которые сравнивают результаты пациентов, которые находятся на особом лечении, и контролируют субъект, который не занимает более высокое место в иерархии, все же могут вводить в заблуждение.

Убедительные изучения медицинских препаратов и хирургических процедур обычно получают только в результате рандомизированных испытаний, во время которых пациенты получают лечение или не получают его согласно процессу, аналогичному подбрасыванию монеты. Правильно проведенные рандомизированные испытания включают в себя дополнительные меры безопасности против предвзятости, в том числе использование препаратов плацебо, что позволяет исследователям скрыть от пациентов и тех, кто за ними ухаживает, тот факт, проходят ли пациенты активное лечение или нет.

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