Evidence-based medicine (EBM) optimizes clinical decision making by dictating that clinical decisions be based on the best available research evidence and by integrating best research evidence with clinical expertise and patient values. Several rankings of the strength of the evidence generated from different types of clinical research designs have been presented, and, in addressing a particular problem, clinicians can base their decision making on the types of clinical reports that have been published, along with an assessment of the strengths and weaknesses of each study. At a policy level, the concept of EBM would dictate that policy decisions also be made based on the best available research evidence. In transfusion medicine, however, decisions are based on a broader range of inputs, and the criteria for evaluating the efficacy and/or cost-effectiveness of proposed interventions differ from those used in other areas. Reasons why policy decisions are often based on considerations other than the best research evidence include public expectations about transfusion safety and proposals for applying the precautionary principle to transfusion medicine. Using the debate over the appropriateness of introducing universal white-cell reduction as an example, this review describes 2 perspectives for assessing evidence and/or making clinical or policy decisions: the evidence-based approach and the precautionary-principle approach; and also considers whether decisions in transfusion medicine can be truly evidence based.

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循证医学的输血实践：这可能吗，这两个词是什么意思？

循证医学（EBM）通过指示临床决策基于最佳可用研究证据，并将最佳研究证据与临床专业知识和患者价值相结合，从而优化临床决策。已经提出了从不同类型的临床研究设计中产生的证据强度的几个等级，并且，为了解决特定问题，临床医生可以根据已发表的临床报告的类型以及对每个研究的优缺点。在政策层面，循证医学的概念将决定也要根据现有的最佳研究证据制定政策。但是，在输血医学中，决策是基于更广泛的投入，评估提议的干预措施的功效和/或成本效益的标准不同于其他领域。政策决策通常基于最佳研究证据以外的考虑因素的原因包括公众对输血安全的期望以及将预防原则应用于输血医学的建议。本文以关于普遍采用白细胞减少的适当性的辩论为例，该综述描述了两种评估证据和/或做出临床或政策决策的观点：基于证据的方法和预防原则。并考虑输血医学中的决策是否可以真正基于证据。政策决策通常基于最佳研究证据以外的考虑因素的原因包括公众对输血安全的期望以及将预防原则应用于输血医学的建议。本文以关于普遍采用白细胞减少的适当性的辩论为例，该综述描述了两种评估证据和/或做出临床或政策决策的观点：基于证据的方法和预防原则。并考虑输血医学中的决策是否可以真正基于证据。政策决策通常基于最佳研究证据以外的考虑因素的原因包括公众对输血安全的期望以及将预防原则应用于输血医学的建议。本文以关于普遍采用白细胞减少的适当性的辩论为例，该综述描述了两种评估证据和/或做出临床或政策决策的观点：基于证据的方法和预防原则。并考虑输血医学中的决策是否可以真正基于证据。本文以关于普遍采用白细胞减少的适当性的辩论为例，该综述描述了两种评估证据和/或做出临床或政策决策的观点：基于证据的方法和预防原则。并考虑输血医学中的决策是否可以真正基于证据。本文以关于普遍采用白细胞减少的适当性的辩论为例，该综述描述了两种评估证据和/或做出临床或政策决策的观点：基于证据的方法和预防原则。并考虑输血医学中的决策是否可以真正基于证据。