MisunderstandingofEBM知识管理KMKnowledge-台北市立万芳医院.pptVIP

實證醫學與醫療品質改善之應用 Presented by : Dr.陳杰峰clifchen@ http://clifchen.idv.tw 自我介紹 現任 萬芳醫院整形外科主治醫師 萬芳醫院實證醫學中心主任 台北醫學大學公共衛生學系講師 學歷 中國醫藥學院醫學系醫學士 Johns Hopkins University, M.P.H.公共衛生學碩士 台北醫學大學醫學資訊研究所博士班研究生 研究主題：醫療決策輔助系統 學習型組織 學習型組織擅長創造知識、取得知識、傳遞知識，並且配合這些新知識和新見解，改變員工行為或調整操作方式。學習型組織，主要從事五項活動，包括： 系統化解決問題 實驗新方法 向他人學習 從歷史中學習 知識傳播 Initially, EBM grew as a bottom-up approach to continuing medical education under the name of Clinical Epidemiology (CE). Sackett DL, Haines RB, Tugwell P. Clinical epidemiology. Boston, Little, Brown Co, 1985 A CASE STUDY OF EBM 荷爾蒙補充療法 NHLBI Stops Trial of Estrogen Plus ProgestinDue to Increased Breast Cancer Risk, Lack of Overall Benefit The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) has stopped early a major clinical trial of the risks and benefits of combined estrogen and progestin in healthy menopausal women due to an increased risk of invasive breast cancer. The report from the WHI investigators on the estrogen plus progestin study findings will be published in the July 17 issue of The Journal of the American Medical Association (JAMA); because of the importance of the information, the study is being released early on Tuesday, July 9, as an expedited article on the JAMA Web site. (Full text version available to all at .) The estrogen plus progestin trial of the WHI involved 16,608 women ages 50 to 79 years with an intact uterus. An important objective of the trial was to examine the effect of estrogen plus progestin on the prevention of heart disease and hip fractures, and any associated change in risk for breast and colon cancer. The study did not address the short-term risks and benefits of hormones for the treatment of menopausal symptoms. Women enrolled in the estrogen plus progestin study were randomly assigned to a daily dose of estrogen plus progestin or to a placebo. The WHI results-- During 1 year, among 10,000 postmenopausal women with a uterus who are taking estrogen plus