Notfall + Rettungsmedizin

, Volume 11, Issue 1, pp 6–11 | Cite as

Evidenzbasierte Medizin in der Notfallmedizin

EBNM/EBEM – Ein Rückblick
Leitthema
First Online:

Zusammenfassung

Evidenzbasierte Notfallmedizin (EBNM) bzw. „evidence based emergency medicine“ (EBEM) ist ein Begriff, der zum Ausdruck bringen soll, dass Effektivität und Effizienz von Methoden, Verfahren, Medikationen etc. in der Notfallmedizin – wo immer möglich – durch wissenschaftliche Beweise belegt werden müssen, bevor sie in die ärztliche Praxis umgesetzt werden. Nur so kann die Lücke zwischen Forschung einerseits und klinischer Praxis andererseits überbrückt werden. Die Hintergründe der 10-jährigen Entwicklung der EBEM werden ebenso erwähnt wie Definitionen und Inhalte präzisiert. Für die Quellensuche sowie die Umsetzung der EBEM in die Praxis haben insbesondere die Cochrane-Kollaborationen, ILCOR, AWMF und andere Fachgesellschaften Bedeutung erlangt. Probleme und Grenzen der EBEM sind in der Vergangenheit evident geworden, sie werden auch für die Zukunft Bedeutung behalten.

Schlüsselwörter

Notfallmedizin Evidenz Forschung Leitlinien 

Evidence based emergency medicine (EBEM): a review

Abstract

Evidence based (emergency) medicine EB(E)M is a term referring to the application into daily clinical practice of only those methods, procedures, medications etc. which are based on scientific evidence. This concept may allow to bridge the gap between research and clinical practice, and represents the major goal of EB(E)M. The background of the development of EBEM over 10 years (from1997 to 2007) is summarized, and definitions as well as contents of the terminology are outlined. EBEM-resources are provided by the Cochrane collaborations, ILCOR, AWMF and other medical organizations. They also provide insights into guidelines and recommendations and are responsible for Knowledge Translation (KT) into clinical practice. Problems and limits of EBEM have been identified in the past, they will remain of importance even in the future.

Keywords

Emergency medicine Evidence Research Guidelines 
This is a preview of subscription content, log in to check access.

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Literatur

  1. 1.
    American Heart Association (1997) ECC template for evidence based reviews. Curr Emerg Card Care 8: 4–5Google Scholar
  2. 2.
    American Heart Association, International Liaison Committee on Resuscitation (2000) Guidelines 2000 for CPR and ECC: An international consensus on science. Resuscitation 46: 1–448CrossRefGoogle Scholar
  3. 3.
    Bastian H (2006) They would say that, wouldn’t they? A readers‘ guide to author and sponsor biases in clinical research. J R Soc Med 99: 611–614PubMedCrossRefGoogle Scholar
  4. 4.
    Calaham M (1992) Associate editors report: Review of papers submitted. Soc Acad Emerg Med IV: 3–4Google Scholar
  5. 5.
    Centre for Evidence based Medicine (2006) Glossary. Key terms in EBP. http://www.cebm.net/index.aspx?o=1116Google Scholar
  6. 6.
    Cordell WH (2002) Evidence based emergency medicine. Online based emergency medicine. Ann Emerg Med 39: 178–180PubMedCrossRefGoogle Scholar
  7. 7.
    Dawes M (2001) Practice of evidence based medicine. University of Oxford, 9th April 2001, http://cebm.jr2.ox.ac.uk/Google Scholar
  8. 8.
    Del Mar C, Glasziou P, Mayer I (2004) Teaching evidence based medicine. BMJ 329: 989–990CrossRefGoogle Scholar
  9. 9.
    Dick, WF(1998) Evidence based emergency medicine. Anaesthesist 47: 957–967PubMedCrossRefGoogle Scholar
  10. 10.
    Edmond SD, Wyer PC, Brown MD et al. (2002) How relevant are the systematic reviews in the Cochrane library to the emergency medical practice? Ann Emerg Med 39: 153–158CrossRefGoogle Scholar
  11. 11.
    Evidence Based Medicine Working Group (1992) Evidence based medicine: A new approach to teaching the practice of medicine. JAMA 268: 2420–25CrossRefGoogle Scholar
  12. 12.
    Guyatt G, Rennie D (1993) The users‘ guide to the medical literature. JAMA 270: 2096–2097PubMedCrossRefGoogle Scholar
  13. 13.
    Guyatt GH (1997) Evidence based emergency medicine. Ann Emerg Med 30: 675–676PubMedCrossRefGoogle Scholar
  14. 14.
    Guyatt GH, Sackett DL, Sinclair JC et al. (1995) Users‘ guides to the medical literature. A method for grading health care recommendations. JAMA 274: 1800–1804PubMedCrossRefGoogle Scholar
  15. 15.
    International Liaison Committee on Resuscitation (2005) 2005 International Consensus on CPR and ECC science with treatment recommendations. Resuscitation 67: 157–336CrossRefGoogle Scholar
  16. 16.
    Lecky F (1997) What is evidence based medicine? Eur J Emerg Med 4: 240CrossRefGoogle Scholar
  17. 17.
    Mackway-Jones K (2004) Towards evidence based emergency medicine: Best BETS from the Manchester Royal Infirmary. Emerg Med J 21: 199–204CrossRefGoogle Scholar
  18. 18.
    Mackway-Jones K, Carley SD, Morton RJ, Donnan S (1998) The best evidence topic report: a modified CAT for summarizing the available evidence in emergency medicine. J Accid Emerg Med 15: 222–226PubMedGoogle Scholar
  19. 19.
    McAlister FA, Straus SE, Guyatt GH, Haynes RB (2000) Users‘ guides to the medical literature: XX. Integrating research evidence with the care of the individual patient. Evidence-Based-Medicine Working Group. JAMA 283: 2829–2836PubMedCrossRefGoogle Scholar
  20. 20.
    Miles A (1997) Evidence-based medicine. Eur J Emerg Med 4: 246–24CrossRefGoogle Scholar
  21. 21.
    National Academy of Sciences, National Research Council (1966) Cardiopulmonary resuscitation. Statement by the ad hoc committe on CPR of the Division of Medical Sciences. JAMA 198: 372–379CrossRefGoogle Scholar
  22. 22.
    Neale AV, Schwartz KL, Bowman MA (2005) Conflict of interest: Can we minimize ist influence in the biomedical literature? J Am Board Fam Pract 18: 411–413PubMedCrossRefGoogle Scholar
  23. 23.
    Ospina MB, Kelly K, Klassen TP, Rowen BH (2006) Publication bias of RCTs in emergency medicine. Acad Emerg Med 13: 102–108PubMedCrossRefGoogle Scholar
  24. 24.
    Porzsold F, Kunz R (1997) Unterschiede zwischen Evidence-Based Medicine und konventionell bester Medizin. Med Klin 92: 567–569Google Scholar
  25. 25.
    Raspe H (1996) Evidence based medicine. Modischer Unsinn, alter Wein in neuen Schläuchen oder aktuelle Notwendigkeit? Zae F 90: 553–562Google Scholar
  26. 26.
    Rosenberg WM, Donald A (1995) Evidence based medicine: an approach to clinical problem solving. BMJ 310: 1122–1126PubMedGoogle Scholar
  27. 27.
    Sackett DL, Rosenberg WM (1995) The need for EBM. J R Soc Med 88: 620–624PubMedGoogle Scholar
  28. 28.
    Sackett DL, Rosenberg WM, Gray JA et al. (1996) Evidence based medicine: What it is and what it isn’t? BMJ 312: 71–72PubMedGoogle Scholar
  29. 29.
    Tonelli MR (1998) The philosophical limits of evidence-based medicine. Acad Med 73: 1234–1240PubMedCrossRefGoogle Scholar
  30. 30.
    Waeckerle JF, Cordell WH, Wyer P, Osborn HH (1997) Evidence based emergency medicine: integrating research in practice. Ann Emerg Med 30: 626–628PubMedCrossRefGoogle Scholar
  31. 31.
    Wilson MC, Hayward RS, Tunis SR et al. (1995) Users‘ guides to medical literature: VIII. How to use clinical practice guidelines. A. Are the recommendations valid? The Evidence-Based Medicine Working Group. JAMA 274: 570–574PubMedCrossRefGoogle Scholar
  32. 32.
    Wilson MC, Hayward RS, Tunis SR et al. (1995) Users‘ guides to the medical literature: VIII. How to use clinical practice guidelines. B. What are the recommendations and will they help you in caring for your patients? The Evidence-Based Medicine Working Group. JAMA 274:1630–1632PubMedCrossRefGoogle Scholar
  33. 33.
    Wyer PC, Allen TY, Corrall CJ (2003) How to find evidence when you need it, part 4: Matching clinical questions to appropriate databases. Ann Emerg Med 42: 136–149PubMedCrossRefGoogle Scholar
  34. 34.
    Wyer PC, Rowe BH, Guyatt GH, Cordell WH (2000) Evidence based emergency medicine. The clinician and the medical literature: when can we take a shortcut? Ann Emerg Med 36: 149–155PubMedCrossRefGoogle Scholar
  35. 35.
    Yates D (1997) Randomized controlled trials and evidence based medicine – What’s in a name. Europ J Emerg Med 4: 123–124CrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag 2008

Authors and Affiliations

  1. 1.MainzDeutschland

Personalised recommendations