Organised cervical screening programmes are a combination of arrangements designed to maximise benefit and minimise harm associated with cervical cancer at the population level. Many organised programmes are described as 'evidence-based', reflecting an expectation that healthcare should be based on the tenets of Evidence-Based Medicine (EBM). EBM is both normalised and contested. As part of a larger study of how cervical screening came to be the way it is, we conducted a grounded theory study of cervical screening experts' perspectives on evidence and its use in guideline development processes. We sampled from several countries and across a range of professional backgrounds. Analysis was developed through transcript coding and memo writing, using constant comparison to develop insight and connections between concepts. We found that the 'evidence-based' descriptor was used rhetorically to indicate scientific trustworthiness; in short 'evidence-based' indicated 'good'. Experts held ideal conceptions of evidence and its use as objective and value-free, yet reported experiences that suggested those ideals were unattainable in practice. The 'evidence-based' ideal included restricting what counts as evidence to matters of science and epidemiology. This produced pronounced attention to matters of efficacy and effectiveness of cervical screening tests, and neglected decisions relating to the other arrangements that combine to produce an organised screening programme. Rhetorical use of the 'evidence-based brand' appeals to a particular kind of authority: one which is difficult to achieve in practice, and belies the variety of information that is required and the socially negotiated nature of policy and programme decisions.

中文翻译：

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循证宫颈癌筛查：专家的规范性证据观和“循证品牌”的作用

有组织的宫颈癌筛查计划是一系列安排的组合，旨在最大限度地提高人群水平上与宫颈癌相关的利益并最大限度地减少危害。许多有组织的计划被描述为“基于证据”，反映了医疗保健应基于循证医学 (EBM) 原则的期望。EBM 既是规范化的，也是有争议的。作为对宫颈筛查如何成为现在的方式的更大研究的一部分，我们对宫颈筛查专家对证据的观点及其在指南制定过​​程中的使用进行了扎根理论研究。我们从多个国家和不同专业背景中取样。分析是通过抄本编码和备忘录写作开发的，使用不断的比较来发展概念之间的洞察力和联系。我们发现，“基于证据的”描述词在修辞上被用来表示科学的可信度；简而言之，“基于证据的”表示“良好”。专家们对证据及其使用的理想概念是客观和无价值的，但报告的经验表明这些理想在实践中是无法实现的。“基于证据”的理想包括将可作为证据的内容限制在科学和流行病学问题上。这引起了对宫颈筛查测试的功效和有效性问题的明显关注，而忽视了与其他安排相关的决定，这些安排结合起来产生了一个有组织的筛查计划。“基于证据的品牌”的修辞使用诉诸于一种特殊的权威：一种在实践中难以实现的权威，