Displaying publications 21 - 40 of 128 in total

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  1. Arienti C, Kiekens C, Bettinsoli R, Engkasan JP, Gimigliano F, Grubisic F, et al.
    Eur J Phys Rehabil Med, 2020 Feb;56(1):120-125.
    PMID: 32093464 DOI: 10.23736/S1973-9087.20.06188-2
    During its third year of existence, Cochrane Rehabilitation goals included to point out the main methodological issues in rehabilitation research, and to increase the Knowledge Translation activities. This has been performed through its committees and specific projects. In 2019, Cochrane Rehabilitation worked on five different special projects at different stages of development: 1) a collaboration with the World Health Organization to extract the best evidence for Rehabilitation (Be4rehab); 2) the development of a reporting checklist for Randomised Controlled Trials in rehabilitation (RCTRACK); 3) the definition of what is the rehabilitation for research purposes; 4) the ebook project; and 5) a prioritization exercise for Cochrane Reviews production. The Review Committee finalized the screening and "tagging" of all rehabilitation reviews in the Cochrane library; the Publication Committee increased the number of international journals with which publish Cochrane Corners; the Education Committee continued performing educational activities such as workshops in different meetings; the Methodology Committee performed the second Cochrane Rehabilitation Methodological Meeting and published many papers; the Communication Committee spread the rehabilitation evidence through different channels and translated the contents in different languages. The collaboration with several National and International Rehabilitation Scientific Societies, Universities, Hospitals, Research Centers and other organizations keeps on growing.
    Matched MeSH terms: Evidence-Based Medicine*
  2. Negrini S, Arienti C, Gimigliano F, Grubišić F, Howe T, Ilieva E, et al.
    Am J Phys Med Rehabil, 2018 01;97(1):68-71.
    PMID: 28953033 DOI: 10.1097/PHM.0000000000000832
    Matched MeSH terms: Evidence-Based Medicine*
  3. Flaherty GT, Lim Yap K
    J Travel Med, 2017 Sep 01;24(5).
    PMID: 28498914 DOI: 10.1093/jtm/tax024
    Evidence-based travel medicine requires that research priorities reflect the wide knowledge base of this discipline. Bibliometric analysis of articles published in Journal of Travel Medicine yielded the following results: epidemiology (6%, n = 105); immunology/vaccinology (8.5%, n = 148); pre-travel assessment/consultation (30.5%, n = 533); diseases contracted during travel (48.3%, n = 843); other clinical conditions associated with travel (6.8%, n = 119); post-travel assessment (5.2%, n = 91) and administrative and general travel medicine issues (6%, n = 105).
    Matched MeSH terms: Evidence-Based Medicine*
  4. Lai NM, Teng CL, Nalliah S
    Educ Health (Abingdon), 2012 Jul;25(1):33-9.
    PMID: 23787382
    CONTEXT: The Fresno test and the Berlin Questionnaire are two validated instruments for objectively assessing competence in evidence-based medicine (EBM). Although both instruments purport to assess a comprehensive range of EBM knowledge, they differ in their formats. We undertook a preliminary study using the adapted version of the two instruments to assess their correlations when administered to medical students. The adaptations were made mainly to simplify the presentation for our undergraduate students while preserving the contents that were assessed.
    METHODS: We recruited final-year students from a Malaysian medical school from September 2006 to August 2007. The students received a structured EBM training program within their curriculum. They took the two instruments concurrently, midway through their final six months of training. We determined the correlations using either the Pearson's or Spearman's correlation depending on the data distribution.
    RESULTS: Of the 120 students invited, 72 (60.0%) participated in the study. The adapted Fresno test and the Berlin Questionnaire had a Cronbach's alfa of 0.66 and 0.70, respectively. Inter-rater correlation (r) of the adapted Fresno test was 0.9. The students scored 45.4% on average [standard deviation (SD) 10.1] on the Fresno test and 44.7% (SD 14.9) on the Berlin Questionnaire (P = 0.7). The overall correlation between the two instruments was poor (r = 0.2, 95% confidence interval: -0.07 to 0.42, P = 0.08), and correlations remained poor between items assessing the same EBM domains (r = 0.01-0.2, P = 0.07-0.9).
    DISCUSSION: The adapted versions of the Fresno test and the Berlin Questionnaire correlated poorly when administered to medical students. The two instruments may not be used interchangeably to assess undergraduate competence in EBM.
    Matched MeSH terms: Evidence-Based Medicine/education*; Evidence-Based Medicine/standards
  5. Su TT, Bulgiba AM, Sampatanukul P, Sastroasmoro S, Chang P, Tharyan P, et al.
    Prev Med, 2013;57 Suppl:S5-7.
    PMID: 23624253 DOI: 10.1016/j.ypmed.2013.04.009
    Clinical Epidemiology (CE) and Evidence-Based Medicine (EBM) have become increasingly important in an era of rising costs, patient safety concerns and evidence-based health care. CE and EBM research in the Asia Pacific region have grown significantly. However, there are three main challenges such as linking evidence to practice and policy; developing a strong collaborative network; and a need for resources and technical expertise to produce evidence. The Cochrane Collaboration is a possible solution to resolve above challenges identified, particularly the challenge of transforming evidence to practice. In addition, training can be carried out to enhance technical expertise in the region and there is also the promising potential that collaborations could extend beyond systematic reviews. To improve the adoption of evidence-based health policy, selection of the best evidence for the right audience and focusing on the relevant issues through appropriate methodology are essential. Information on effectiveness and cost effectiveness needs to be highlighted for policy makers. The way forward to strengthen research and capacity building is to establish the Asia Pacific Consortium for CE and EBM. The consortium would help to create mutually rewarding scientific research and collaborations that will augur well for advances in CE and EBM.
    Matched MeSH terms: Evidence-Based Medicine/organization & administration*; Evidence-Based Medicine/standards
  6. Maloney S, Nicklen P, Rivers G, Foo J, Ooi YY, Reeves S, et al.
    J Med Internet Res, 2015;17(7):e182.
    PMID: 26197801 DOI: 10.2196/jmir.4346
    Blended learning describes a combination of teaching methods, often utilizing digital technologies. Research suggests that learner outcomes can be improved through some blended learning formats. However, the cost-effectiveness of delivering blended learning is unclear.
    Matched MeSH terms: Evidence-Based Medicine/economics*; Evidence-Based Medicine/education*
  7. Norhayati MN, Nawi ZM
    PLoS One, 2021;16(4):e0249660.
    PMID: 33886615 DOI: 10.1371/journal.pone.0249660
    BACKGROUND: Evidence-based medicine (EBM) is a widely accepted scientific advancement in clinical settings that helps achieve better, safer, and more cost-effective healthcare. However, presently, validated instruments to evaluate healthcare professionals' attitude and practices toward implementing EBM are not widely available. Therefore, the present study aimed to determine the validity and reliability of a newly developed knowledge, attitude, and practice (KAP) questionnaire on EBM for use among healthcare professionals.

    METHODS: The Noor Evidence-Based Medicine Questionnaire was tested among physicians in a government hospital between July and August 2018. Exploratory factor analysis and internal consistency reliability-based Cronbach's alpha statistic were conducted.

    RESULTS: The questionnaire was distributed among 94 physicians, and 90 responded (response rate of 95.7%). The initial number of items in the KAP domains of the Noor Evidence-Based Medicine Questionnaire were 15, 17, and 13, respectively; however, two items in the practice domain with communalities <0.25 and factor loadings <0.4 were removed. The factor structure accounted for 52.33%, 66.29%, and 55.39% of data variance in the KAP domains, respectively. Cronbach's alpha values were 0.81, 0.81, and 0.84 for KAP domains, respectively, indicating high reliability.

    CONCLUSIONS: This questionnaire can be used to evaluate the knowledge, attitudes, and behaviour of healthcare professionals toward EBM. Future testing of this questionnaire among other medical personnel groups will help expand the scope of this tool.

    Matched MeSH terms: Evidence-Based Medicine/methods*; Evidence-Based Medicine/trends*
  8. Ahmad Badruddin Ghazali, Nur Imanina Abdullah Thaidi
    MyJurnal
    The purpose of this study was to integrate the available data published to date on susuk or charm needles into a com- prehensive analysis of their clinical/radiological features. An electronic search was undertaken in September 2019. Eligibility criteria included publications having enough clinical and radiological to confirm a definite diagnosis. The initial literature search resulted in 48 publications. Ten publications were excluded for duplicates, and another 17 excluded after a screening of the abstract. Besides, the screening of the abstract shows that five publications were not meeting the inclusion criteria, resulting in a total of 14 publications of susuk that were included in the systematic review. Bias analysis was conducted according to Oxford Center for Evidence-Based Medicine. The resulting total of 78 cases from the selected publications were analysed, showing a wide age range with different distribution among gender and ethnicity. Three cases reported in the literature having symptoms related to susuk. Susuk can be seen as an incidental finding during a routine radiographic assessment, and clinicians should be able to differentiate it from other radiopaque foreign bodies. The practice is not limited to South East Asian population and can be seen in wide racial profiles.
    Matched MeSH terms: Evidence-Based Medicine
  9. Lai NM
    Malays Fam Physician, 2013;8(2):7-12.
    PMID: 25606275 MyJurnal
    Evidence-based medicine (EBM) was introduced to provide an organised approach to clinicians and other health care providers in using research to care for their patients[1]. By highlighting the importance of research in patient care, EBM has also provided many researchers a strong sense of purpose, with increased awareness that their everyday activities are being recognised as relevant to patient care. Most medical schools have some form of the EBM training programme at undergraduate and postgraduate levels, and many researchers, clinical epidemiologists, and biostatisticians together with clinicians are actively engaged in teaching EBM to students of medicine and other health sciences. However, the flourishing activities of EBM education bring along
    challenges.
    Matched MeSH terms: Evidence-Based Medicine
  10. Khalib, A.L., Nirmalini, R.
    MyJurnal
    Introduction : It is no doubt that the success of any health organization depends so closely on its managerial functions. To achieve this, the leader or manager as the core strategist of its organization must in all time be updated with the latest evidence-based information so that he or she can be easily operationalized his or her management function in more effective and sustainable manners. It depends largely on scientific literatures that published relevant articles within this scope. Unfortunately, management topics related to health care system is scattered published and this has indirectly affect manager to access the latest scientific documents.
    Methods : We examined the practice of well known international journal in health care namely New England Medical Journal (NEMJ) on its role in propagating latest health management topics to its prospective clients.
    Results : The result showed that a total of 31% health management topics were published throughout 2007 out of 1140 articles appeared. Of these, about 33% were confined to general health administration. The remaining articles were related to healthcare delivery practices (24%), medical ethics and legal matters (17% each), and manpower issues and training (9%).
    Conclusion : Focus on managerial related articles relatively low as compared to clinical and other evidence-based medicine that clearly dominated health management issues.
    Matched MeSH terms: Evidence-Based Medicine
  11. Teng CL, Wong CH
    Malays Fam Physician, 2013;8(3):26-27.
    PMID: 25883762 MyJurnal
    A 21-year old medical student consults the doctor for a fever that started 3 days ago. The fever was high grade and associated with generalised body aches. There was no gum bleeding. He mentioned that mosquito fogging was conducted in his neighbourhood recently.Physical examination revealed an alert conscious young man. Temperature (oral): 38.9 ͦ C, blood pressure 100/70 mmHg, pulse rate 90/min, good volume. Mild flushing was noted. No petechiae were seen in his legs. Tourniquet test was positive.
    Matched MeSH terms: Evidence-Based Medicine
  12. Ho GJ, Liew SM, Ng CJ, Hisham Shunmugam R, Glasziou P
    PLoS One, 2016;11(12):e0167170.
    PMID: 27935993 DOI: 10.1371/journal.pone.0167170
    BACKGROUND: Physicians are often encouraged to locate answers for their clinical queries via an evidence-based literature search approach. The methods used are often not clearly specified. Inappropriate search strategies, time constraint and contradictory information complicate evidence retrieval.

    AIMS: Our study aimed to develop a search strategy to answer clinical queries among physicians in a primary care setting.

    METHODS: Six clinical questions of different medical conditions seen in primary care were formulated. A series of experimental searches to answer each question was conducted on 3 commonly advocated medical databases. We compared search results from a PICO (patients, intervention, comparison, outcome) framework for questions using different combinations of PICO elements. We also compared outcomes from doing searches using text words, Medical Subject Headings (MeSH), or a combination of both. All searches were documented using screenshots and saved search strategies.

    RESULTS: Answers to all 6 questions using the PICO framework were found. A higher number of systematic reviews were obtained using a 2 PICO element search compared to a 4 element search. A more optimal choice of search is a combination of both text words and MeSH terms. Despite searching using the Systematic Review filter, many non-systematic reviews or narrative reviews were found in PubMed. There was poor overlap between outcomes of searches using different databases. The duration of search and screening for the 6 questions ranged from 1 to 4 hours.

    CONCLUSION: This strategy has been shown to be feasible and can provide evidence to doctors' clinical questions. It has the potential to be incorporated into an interventional study to determine the impact of an online evidence retrieval system.

    Matched MeSH terms: Evidence-Based Medicine/methods*; Evidence-Based Medicine/standards; Evidence-Based Medicine/statistics & numerical data
  13. Ang CS, Chan KM
    Med J Malaysia, 2016 06;71(Suppl 1):42-57.
    PMID: 27801387 MyJurnal
    Coronary artery disease is the major cause of mortality and morbidity in Malaysia and worldwide. This paper reviews all research and publications on coronary artery disease in Malaysia published between 2000-2015. 508 papers were identified of which 146 papers were selected and reviewed on the basis of their relevance. The epidemiology, etiology, risk factors, prevention, assessment, treatment, and outcomes of coronary artery disease in the country are reviewed and summarized. The clinical relevance of the studies done in the country are discussed along with recommendations for future research.
    Matched MeSH terms: Evidence-Based Medicine
  14. Zia A, Kamaruzzaman SB, Tan MP
    Postgrad Med, 2015 Apr;127(3):330-7.
    PMID: 25539567 DOI: 10.1080/00325481.2014.996112
    The term polypharmacy has negative connotations due to its association with adverse drug reactions and falls. This spectrum of adverse events widens when polypharmacy occurs among the already vulnerable geriatric population. To date, there is no consensus definition of polypharmacy, and diverse definitions have been used by various researchers, the most common being the consumption of multiple number of medications. Taking multiple medications is considered a risk factor for falls through the adverse effects of drug-drug or drug-disease interactions. Falls studies have determined that taking ≥ 4 drugs is associated with an increased incidence of falls, recurrent falls, and injurious falls. In light of existing evidence, careful and regular medication reviews are advised to reduce the effect of polypharmacy on falls. However, intervention studies on medication reviews and their effectiveness on falls reduction have been scarce. This article reviews and discusses the evidence behind polypharmacy and its association with falls among older individuals, and highlights important areas for future research.
    Matched MeSH terms: Evidence-Based Medicine*
  15. Lai NM, Teng CL
    BMC Med Educ, 2011;11:25.
    PMID: 21619672 DOI: 10.1186/1472-6920-11-25
    BACKGROUND: Previous studies report various degrees of agreement between self-perceived competence and objectively measured competence in medical students. There is still a paucity of evidence on how the two correlate in the field of Evidence Based Medicine (EBM). We undertook a cross-sectional study to evaluate the self-perceived competence in EBM of senior medical students in Malaysia, and assessed its correlation to their objectively measured competence in EBM.
    METHODS: We recruited a group of medical students in their final six months of training between March and August 2006. The students were receiving a clinically-integrated EBM training program within their curriculum. We evaluated the students' self-perceived competence in two EBM domains ("searching for evidence" and "appraising the evidence") by piloting a questionnaire containing 16 relevant items, and objectively assessed their competence in EBM using an adapted version of the Fresno test, a validated tool. We correlated the matching components between our questionnaire and the Fresno test using Pearson's product-moment correlation.
    RESULTS: Forty-five out of 72 students in the cohort (62.5%) participated by completing the questionnaire and the adapted Fresno test concurrently. In general, our students perceived themselves as moderately competent in most items of the questionnaire. They rated themselves on average 6.34 out of 10 (63.4%) in "searching" and 44.41 out of 57 (77.9%) in "appraising". They scored on average 26.15 out of 60 (43.6%) in the "searching" domain and 57.02 out of 116 (49.2%) in the "appraising" domain in the Fresno test. The correlations between the students' self-rating and their performance in the Fresno test were poor in both the "searching" domain (r = 0.13, p = 0.4) and the "appraising" domain (r = 0.24, p = 0.1).
    CONCLUSIONS: This study provides supporting evidence that at the undergraduate level, self-perceived competence in EBM, as measured using our questionnaire, does not correlate well with objectively assessed EBM competence measured using the adapted Fresno test.
    STUDY REGISTRATION: International Medical University, Malaysia, research ID: IMU 110/06.
    Matched MeSH terms: Evidence-Based Medicine*
  16. Lai NM, Teng CL
    Hong Kong Med J, 2009 Oct;15(5):332-8.
    PMID: 19801689
    OBJECTIVE: To assess the impact of a structured, clinically integrated evidence-based undergraduate medicine training programme using a validated tool. DESIGN. Before and after study with no control group.
    SETTING: A medical school in Malaysia with an affiliated district clinical training hospital.
    PARTICIPANTS: Seventy-two medical students in their final 6 months of training (senior clerkship) encountered between March and August 2006.
    INTERVENTION: Our educational intervention included two plenary lectures at the beginning of the clerkship, small-group bedside question-generating sessions, and a journal club in the paediatric posting.
    MAIN OUTCOME MEASURES: Our primary outcome was evidence-based medicine knowledge, measured using the adapted Fresno test (score range, 0-212) administered before and after the intervention. We evaluated the performance of the whole cohort, as well as the scores of different subgroups that received separate small-group interventions in their paediatric posting. We also measured the correlation between the students' evidence-based medicine test scores and overall academic performances in the senior clerkship.
    RESULTS: Fifty-five paired scripts were analysed. Evidence-based medicine knowledge improved significantly post-intervention (means: pre-test, 84 [standard deviation, 24]; post-test, 122 [22]; P<0.001). Post-test scores were significantly correlated with overall senior clerkship performance (r=0.329, P=0.014). Lower post-test scores were observed in subgroups that received their small-group training earlier as opposed to later in the clerkship.
    CONCLUSIONS: Clinically integrated undergraduate evidence-based medicine training produced an educationally important improvement in evidence-based medicine knowledge. Student performance in the adapted Fresno test to some extent reflected their overall academic performance in the senior clerkship. Loss of evidence-based medicine knowledge, which might have occurred soon after small-group training, is a concern that warrants future assessment.
    Matched MeSH terms: Evidence-Based Medicine/education*
  17. SEA-ORCHID Study Group, Laopaiboon M, Lumbiganon P, McDonald SJ, Henderson-Smart DJ, Green S, et al.
    PLoS One, 2008 Jul 09;3(7):e2646.
    PMID: 18612381 DOI: 10.1371/journal.pone.0002646
    BACKGROUND: The burden of mortality and morbidity related to pregnancy and childbirth remains concentrated in developing countries. SEA-ORCHID (South East Asia Optimising Reproductive and Child Health In Developing countries) is evaluating whether a multifaceted intervention to strengthen capacity for research synthesis, evidence-based care and knowledge implementation improves adoption of best clinical practice recommendations leading to better health for mothers and babies. In this study we assessed current practices in perinatal health care in four South East Asian countries and determined whether they were aligned with best practice recommendations.

    METHODOLOGY/PRINCIPAL FINDINGS: We completed an audit of 9550 medical records of women and their 9665 infants at nine hospitals; two in each of Indonesia, Malaysia and The Philippines, and three in Thailand between January-December 2005. We compared actual clinical practices with best practice recommendations selected from the Cochrane Library and the World Health Organization Reproductive Health Library. Evidence-based components of the active management of the third stage of labour and appropriately treating eclampsia with magnesium sulphate were universally practiced in all hospitals. Appropriate antibiotic prophylaxis for caesarean section, a beneficial form of care, was practiced in less than 5% of cases in most hospitals. Use of the unnecessary practices of enema in labour ranged from 1% to 61% and rates of episiotomy for vaginal birth ranged from 31% to 95%. Other appropriate practices were commonly performed to varying degrees between countries and also between hospitals within the same country.

    CONCLUSIONS/SIGNIFICANCE: Whilst some perinatal health care practices audited were consistent with best available evidence, several were not. We conclude that recording of clinical practices should be an essential step to improve quality of care. Based on these findings, the SEA-ORCHID project team has been developing and implementing interventions aimed at increasing compliance with evidence-based clinical practice recommendations to improve perinatal practice in South East Asia.

    Matched MeSH terms: Evidence-Based Medicine*
  18. Firouzi S, Barakatun-Nisak MY, Ismail A, Majid HA, Nor Azmi K
    Int J Food Sci Nutr, 2013 Sep;64(6):780-6.
    PMID: 23484591 DOI: 10.3109/09637486.2013.775227
    Evidences from several studies suggest that probiotics affect glucose homeostasis. This paper reviews the results of animal and human studies on the role of probiotics in modulating glucose homeostasis.
    Matched MeSH terms: Evidence-Based Medicine*
  19. Chan GC, Teng CL
    Med J Malaysia, 2005 Jun;60(2):130-3.
    PMID: 16114151
    A cross sectional study using a self-administered questionnaire to determine the perceptions of primary care doctors towards evidence-based medicine (EBM) was conclucted in Melaka state. About 78% of the primary care doctors were aware of EBM and agreed it could improve patient care. Only 6.7% of them had ever conducted a Medline literature search. They had a low level of awareness of review publications and databases relevant to EBM; only about 33% of them were aware of the Cochrane Database of Systemic Reviews. Over half of the respondents had at least some understanding of the technical terms used in EBM. Ninety percent of the respondents had Internet access and the majority of them used it at home. The main barriers to practicing EBM were lack of personal time and lack of Internet access in the primary care clinics.
    Matched MeSH terms: Evidence-Based Medicine*
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