Question 2: What is the difference between rational decision making and evidence-based decision making?
The connotation of (1) means-goal chain is contradictory, and simple means-goal chain analysis will lead to inaccurate conclusions.
Simon believes that the sequential system of means-goal chain is rarely a systematic and comprehensive chain, and the relationship between organizational activities and basic goals is often vague, and these basic goals are also an incomplete system. There are also conflicts and contradictions between these basic goals and the various means chosen to achieve them.
(2) Decision makers pursue rationality, but they don't pursue rationality to the maximum extent. He only asks for bounded rationality.
This is because people's knowledge is limited, and it is impossible for decision makers to master all the information and know the detailed rules of decision-making. For example, people's computing power is limited, and even with the help of computers, there is no way to deal with a large number of variable equations; People's imagination and design ability are limited, and it is impossible to list all the alternatives; People's value orientation is not static, and their purposes often change; People's purposes are often diverse and contradictory, and there is no unified standard. Therefore, as an individual decision-maker, his bounded rationality restricts him from making completely rational decisions, and he can only try his best to pursue bounded rationality within his ability.
(3) Decision-makers pursue the "satisfaction" standard in decision-making, not the optimal standard.
In the decision-making process, the decision-maker sets a basic requirement and then examines the existing alternatives. If there is an alternative that can better meet the most basic requirements, the decision-maker will reach the satisfaction standard, and he will not want to study or find a better alternative.
This is because, on the one hand, people are often unwilling to give full play to the enthusiasm of continuing research and are only satisfied with the existing alternatives;
On the other hand, due to various constraints, policy makers themselves lack the ability in this area. In real life, you often get a satisfactory solution, not an optimal one.
According to the above points, decision makers admit that the world they feel is only an extreme simplification of the complex real world, and their satisfaction standard is not maximization, so they don't have to determine all possible alternatives. Because they feel that the real world can't be grasped, they are often satisfied with using simple methods and doing things by experience, habits and conventions. So the decision-making results are different.
The viewpoint of (completely) rational decision-making:
1, decision makers are faced with an established problem.
2. The purpose, value or goal of the decision-maker is clear, which can be sorted according to the importance of different goals.
3. Decision makers have more than two choices. Faced with these options, they usually choose one of them on a case-by-case basis. If the plans are basically the same, the same decision will usually be made.
4. For the same problem, decision makers will face one or more natural states. They are uncontrollable factors that are independent of human will. Or it can be said that the preference of decision makers will change with the change of time and space.
5. The decision maker will calculate the profit value (degree) or loss value (degree) of each scheme under different natural conditions, and after comparison, choose the best scheme according to the value preference of the decision maker.
The theory of completely rational decision-making based on the hypothesis of "economic man" is only an ideal model, and it is impossible to guide actual decision-making. Simon's bounded rationality model (the most satisfactory model) is a more realistic model, which holds that human rationality is a bounded rationality between complete rationality and complete irrationality.
You can refer to the information here: baike.baidu/view/889665.
Question 3: How to solve the difficulties in implementing evidence-based decision-making? Four steps:
The first stage: the stage of finding and establishing evidence-systematic evaluation;
Step 1: find the problems in clinical practice and make them concrete and structured;
Step 2: Make a systematic evaluation according to the questions raised, so as to find evidence from scientific research and carefully evaluate the effectiveness and practicability of scientific research evidence.
The second stage: the proof stage, that is, follow the evidence requirements for nursing.
Step 3: Combine the obtained evidence with clinical professional knowledge and experience and patients' requirements to obtain clinical evidence and formulate nursing plan.
Step 4: Implement the nursing plan, and dynamically evaluate the detection effect and the actual situation of the project.
Question 4: What is the significance of systematic evaluation in evidence-based medicine for clinical decision-making? Evidence-based medicine Evidence-based medicine follows scientific evidence. Clinical medicine advocates that clinicians should combine clinical practice and experience with objective scientific evidence to make a correct diagnosis. Safe and effective treatment and accurate pre-estimation serve every specific patient. Evidence-based medicine is the same as traditional medicine. Traditional medical experience means that doctors treat patients according to non-experimental clinical experience, clinical data and basic knowledge of diseases. Evidence-based medicine does not replace clinical skills, clinical experience, clinical data and medical expertise, but only emphasizes that any medical decision should be based on good scientific evidence. In recent years, with the rapid development of evidence-based medicine, network resources are becoming more and more abundant. Cochrane Library, founded by Cochrane Collaboration Network, has become an important database for obtaining evidence-based medical resources. Its high-quality systematic review is praised as providing a good source of scientific evidence. With the rapid development of modern communication technology and biomedical informatics, many well-known biomedical databases, such as MEDLINE, EMBASE, BIOSIS, SCI, China Biomedical Database, etc., have turned from CD-ROM to network, enabling medical professionals to be online in an all-round way. Unbiased literature retrieval can further obtain the abstract content of specific clinical problems and fully meet the information needs of systematic review of evidence-based medicine. At present, the emergence of a large number of online journals has prompted information service agencies and publishers to provide keyword query-abstract-original style services, which provides medical professionals with the opportunity to obtain original texts directly online, but they lack the well-known full-text database OVID, which provides evidence-based medical resources. In addition, with the rise of evidence-based medicine, its website is becoming more and more perfect, covering almost all aspects of evidence-based medicine: systematic review database, clinical practice guide database, evidence-based medicine journals, meta-analysis software, evidence-based medicine teaching resources and navigation. Many of its resources are free, and it has become an important website for clinicians to obtain evidence-based medicine resources.
Question 5: Is evidence-based decision-making one of the seven principles of quality management? Brief introduction to the requirements of ISO900 1:20 15 quality management system. 0.2 specifies the quality management principles as follows:
Customer-centered;
Leadership;
Full participation;
Process method;
Improvement;
Evidence-based decision making;
Relationship management.
Question 6: What is evidence-based medicine? I was invited, but Lu Kexi News and others answered a lot, especially agreeing with Dr. Lu Kexi News and Dr. Tian Jishun. There is no perfect method, and treatment needs to be individualized. Consultation between doctors and patients may change the progress of medicine.
Question 7: What is evidence-based nursing? Evidence-based nursing background
199 1 year, Canadian scholar Guyatt first used the term evidence-based medicine (EBM). 1992, Lsackett of Canada sorted out and perfected the concept of evidence-based medicine, the core idea of which is to apply the best contemporary evidence cautiously, clearly and wisely to make medical decisions for individual patients. With the efforts of British epidemiologist Cochrane, Cochrane collaboration network was established in Britain from 65438 to 0993 to systematically evaluate medical literature. At present, 13 countries including China have been developed; The National Health Forum of Canada actively advocates the creation of a culture of evidence-based decision-making. At present, evidence-based medicine has developed into evidence-based medicine, and a new concept of evidence-based decision-making has been developed not only in the medical field, but also in the fields of nursing and public health. The emergence of evidence-based medicine not only carries forward the tradition of experiment and rationality in western natural science, but also reflects the importance that modern medicine attaches to patients' personal values and expectations.
Evidence-based nursing (EBN) is a nursing concept influenced by evidence-based medicine. In the past decades, great changes have taken place in the nursing discipline, such as the development of patient-centered holistic nursing. Seek the best nursing behavior with critical thinking, implement comprehensive nursing quality improvement procedures, and provide the best service at the lowest cost. Meanwhile. The number of nursing research papers in clinical practice and health service has increased significantly, and nurses have mastered the computer literature retrieval method, which has greatly promoted the development of evidence-based nursing. In recent years, the concept of evidence-based nursing has gradually emerged in the field of nursing.
Question 8: Evidence-based nutrition The emergence of evidence-based nutrition.
Compared with clinical medicine, nutrition serves a wider range of clients. In addition to individual nutritional support for clinical patients, nutritional evaluation and intervention for the public are the main tasks of nutrition. In addition, the relevant knowledge of nutrition needs not only professionals to master, but also popular science education for the public, so that they can consciously develop scientific eating behavior and improve their nutritional status more effectively. Therefore, before nutrition-related policies and measures are put into practice, it is more important to obtain the best research evidence.
In recent years, in order to deeply study the physiological function of nutrients and the prevention and treatment mechanism of related diseases, many advanced biotechnology are often used, and some new understandings are obtained through in vitro culture and animal experiments. However, if these theoretical research results are applied to the human body, they must go through a series of rigorous human experiments. This is why the US Food and Drug Administration (FDA) is particularly cautious when confirming the functional claims of certain nutrients or foods on food labels.
Evidence-based nutrition is the basis of standardizing these human experiments.
Evidence-based practice of nutrition began with clinical nutrition work. From June, 5438 to February, 2000, the American Public Law (106-554) passed by the US Congress and signed by then President Clinton stipulated that the qualification of medical insurance should be extended to medical nutrition treatment (MNT) for patients with diabetes and non-dialysis nephropathy, and the treatment should be provided by registered dieticians (RD) and nutritionists recognized by law. People of insight put forward that this seemingly simple legal change marks the promotion of the professional status of registered dietitians. At the same time, this change also suggests that registered dietitians in the United States and other countries have to face higher requirements for nutrition services from other medical professions and patients, that is, they must change from the traditional nutrition work mode to the evidence-based practice mode.
The more important significance of evidence-based practice for nutrition lies in that many research data are often difficult to reach consistent conclusions. It is a normal phenomenon that there are some arguments and even some absurd views in the development of nutrition. Unfortunately, some arguments and fallacies are widely spread as mature scientific achievements, which guide nutrition practice and cause great ideological confusion in academic circles and the public. For example, some countries in Asia and Europe and America have the theory that acidic and alkaline foods affect health; In recent years, the study of milk carcinogenesis and diabetes has caused great confusion about whether to continue drinking milk; There are also arguments about the harmful and beneficial effects of vitamin supplements, the relationship between vegetarianism and health, and the widespread "food compatibility" in China, and so on. It is difficult to reach a consensus on these issues because people have not yet realized which research materials are the "best scientific evidence" and which research evidence is not enough to form a conclusion. Therefore, in the process of nutrition progress, the emergence of evidence-based nutrition is not only the demand of research and development, but also the inevitable result of research itself.
In recent years, evidence-based practice methods have been increasingly applied to nutrition research and become an effective way to turn a large number of existing documents into practical problems. For policy makers, evidence-based nutrition provides a practical framework for researchers to collect and evaluate all the evidence that may be used for scientific decision-making. For practitioners, evidence-based nutrition is a very effective measure, which can reduce inefficient or ineffective practices and even correct mistakes, and better improve the nutritional status of residents.
Evidence-based nutrition can be applied to many fields of nutrition theory research and guiding practice, such as formulating nutrition standards, dietary guidelines, food guidance, clinical nutrition support and food health claims.
■ The strength of the evidence
The concept of evidence-based nutrition mainly comes from evidence-based medicine, and most scholars define it as "using the best evidence available and systematically reviewed to formulate nutrition policies and implement nutrition actions".
Generally speaking, evidence-based practice mainly includes five steps (five-step evidence-based method): asking questions, retrieving evidence, evaluating evidence, using evidence and self-evaluating. Some authors applied it to nutrition and put forward an eight-step evidence-based method.
One of the main viewpoints of evidence-based nutrition is to emphasize that evidence has different strengths. Therefore, the primary task of evidence-based practice is to divide the research evidence from various sources into different grades, so as to make decisions by using the best research evidence or relatively excellent evidence.
However, in different areas of evidence-based practice, the grading method of evidence strength is different. World Cancer Research Foundation and ... >>
Question 9: The difference between evidence-based medicine and facial medicine in clinical decision-making. The application of clinical decision-making is a multi-dimensional thinking. Evidence-based medicine provides accurate information, but it needs some capital investment. Facial medicine involves many practical verification processes, and I personally think that both are indispensable.