<International Circulation>: The emphasis now in ATP4 and JNC8 is on evidence. Obviously evidence-based guidelines lead to better medicine but do you really feel they lead to better implementation? Isn’t the key point whether guidelines are actually used or not?
<International Circulation>: How much of a place in the Guidelines do you think expert opinion is going to have?
《国际循环》: 您认为专家的观点在指南中占多大比重?
Prof. Stone: We have tried to keep it a low level so that clinicians can better understand the basis for these recommendations.
Stone教授: 我们试图使其维持在一个较低的水平,以使临床医生能够更好地理解指南推荐的基础。
<International Circulation>: Expert opinion is always going to have some place at least in the foreseeable future?
《国际循环》: 专家的观点至少在可预见的未来中科占有一席之地?
Prof. Stone: In terms of patient care, guidelines can’t tell you what to do at every step for every patient. They are simply the foundation for the thought process that goes into solid clinical care. There is still going to be room for experts in the fields of general medicine, cardiology, endocrinology, lipidology and so on who will be there to provide additional knowledge in terms of specific patient care issues confounded by many different types of co-morbidities. Guidelines are not the end; they are the beginning, the foundation of clinical care and then you build your recommendations on that. It means that other people who say you should definitely do this or definitely do that, will be held to a higher standard. Let’s show the basis for that recommendation. That is another unspoken consequence of solid guidelines. It means that those who feel very strongly about an issue will have to present their argument just as strongly as the guidelines.
Stone教授: 在病人的处理方面,指南不能告诉你对于每一个病人每一步如何去做。它们是思维过程如何进入实际的临床医疗的简单的基础。在全科医学、心脏科、内分泌科、脂质科学等领域仍有专家的一席之地,他们将为存在不同类型的合并症的患者的特殊的医疗处理提供额外的支持。指南并不是结束,它们是开始,是临床医疗的基础,是你形成你自己的建议的基石。这意味着其他人告诉你应该做这个而不应该做那个,将遵循更高的一个标准。让我们看一下该建议的基础。这是坚实的指南的另一个不言而喻的结果。它意味着那些坚信某一问题的人将不得不像指南一样证据确凿地提出他们的争论。