[Evidence-based intensive care medicine. Practice, use and significance].
The process of evidence-based medicine incorporates structured clinical problem solving aimed at providing an optimal, patient-centred therapeutic approach. Evidence-based medicine is supported by justified therapeutic principles rather than physicians' intuition only. Few of the published articles allow firm conclusions for a rational patient approach. The methodological quality of at least some of these articles is insufficient to guide rational therapy. Thus, critical appraisal of the literature seems mandatory. The following article highlights the process of evidence-based medicine and its implementation in daily clinical practice. Besides the careful analysis of source data, evidence-based medicine warrants the final evaluation of outcomes for process improvement. This can be obtained utilising surrogate parameters, such as organ failure, resource allocation, or quality of life, or crude mortality of the patients. The integration of personal know-how together with sufficient knowledge and critical appraisal of the current literature may finally lead to improved outcomes.
Graf
J
J
Medizinische Klinik I, Universitätsklinikum Aachen. jgraf@gmx.de
Janssens
U
U
D002407:Catheterization, Swan-Ganz; D003422:Critical Care; D019317:Evidence-Based Medicine; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008991:Monitoring, Physiologic; D010818:Practice Patterns, Physicians'; D016896:Treatment Outcome