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中华临床医师杂志(电子版) ›› 2022, Vol. 16 ›› Issue (11) : 1142 -1145. doi: 10.3877/cma.j.issn.1674-0785.2022.11.019

医学人文

医疗决策中的循证与叙事依据
严楠1, 杜丽雪1, 依斯坎德尔·依沙江1, 宋美娜1, 王非1, 王仲1,()   
  1. 1. 102218 北京,清华大学附属北京清华长庚医院 清华大学临床医学院
  • 收稿日期:2022-04-10 出版日期:2022-11-15
  • 通信作者: 王仲

Evidence-based medicine and narrative evidence in medical decision making

Nan Yan1, Lixue Du1, Yishajiang Yisikandeer1, Meina Song1, Fei Wang1, Zhong Wang1,()   

  1. 1. Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
  • Received:2022-04-10 Published:2022-11-15
  • Corresponding author: Zhong Wang
引用本文:

严楠, 杜丽雪, 依斯坎德尔·依沙江, 宋美娜, 王非, 王仲. 医疗决策中的循证与叙事依据[J]. 中华临床医师杂志(电子版), 2022, 16(11): 1142-1145.

Nan Yan, Lixue Du, Yishajiang Yisikandeer, Meina Song, Fei Wang, Zhong Wang. Evidence-based medicine and narrative evidence in medical decision making[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(11): 1142-1145.

医疗决策是临床工作的重要一环。医疗决策有赖于对患者状态的评价,也有赖于对患者(和家属)心理、躯体感受的评价。本文通过一例恶性肿瘤晚期患者的常规诊疗和安宁疗护过程中的医疗决策过程,分析主观证据和客观证据在决策中的应用,进而分析循证医学和叙事医学在医疗决策中的地位。

Medical decision-making is an important part of clinical work. Medical decisions depend on the evaluation of the patient's state, as well as on the evaluation of the patient's (and family's) psychological and somatic feelings. In this paper, we analyze the application of subjective evidence and objective evidence in decision-making through the medical decision-making process of routine diagnosis/treatment and hospice care of a patient with advanced malignancy, and discuss the status of evidence-based medicine and narrative medicine in medical decision-making.

表1 患者终末期医疗决策中的循证与叙事医学
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