Challenges for the practice of evidence-based medicine during COVID-19 pandemic (practice of evidence-based medicine in the new normal)

Kotur, PremanathFakirayya; Kotur, Pushpa

doi:10.4103/ija.ija_103_22

Cited by 6 publications

(4 citation statements)

References 22 publications

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“…This age-old challenge has worsened in the era of COVID-19. Another study has also confirmed that evidence-based medicine has been shaken during this pandemic and doctors' trust has been eroded due to disagreements in scientific evidence and the publication of misleading scientific articles about COVID-19 ( 44 ).…”

Section: Discussionmentioning

confidence: 87%

The necessity revealed by COVID-19 pandemic: Paradigm shift of Iran's healthcare system

Mohammadpour

Delavari

Kavosi

et al. 2023

Front. Public Health

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BackgroundCOVID-19 pandemic has resulted in drastic changes around the world, revealing vulnerable aspects of healthcare systems. This study aimed to explore how Iranian healthcare system experienced the paradigm shift during the pandemic and determine the aspects that need improvement during the pandemic era.MethodThis qualitative study was conducted in 2021. A framework analysis approach was used to analyze the content of the 19 semi-structured interviews with the healthcare system experts from Shiraz University of Medical Sciences (SUMS). The interviews‘ audio files changed into transcript after each session and data was saturated at the 19 interview. To increase the trustworthiness of the study, Guba and Lincoln's criteria including credibility, transferability, dependability, and confirmability were used. Goldsmith's five-step framework analysis was used applying MAX QDA version 10 software.ResultEight main themes and 20 subthemes were explored. The main themes included “strengthening the electronic health infrastructure,” “research for evidence-based decision making,” “dedicated financing to the pandemic,” “prevention of disruption in the effective provision of services and medicines,” “enriching the authority of the Ministry of Health by focusing on interactions,” “recruiting, managing and empowering health human resources with attention to financial and non-financial incentives,” “reforming educational approaches in training students in medical universities,” as well as “lessons learned from neglected aspects.”ConclusionTo be ready to respond to a possible future pandemic and for a paradigm shift, bold steps must be taken to make fundamental changes in various aspects of the healthcare system including e-health development, evidence-based decision making, dedicated budgets for pandemics, reinforcement of interactions at the national and international level, as well as sufficient attention to healthcare workers from all financial, non-financial and educational aspects.

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Section: Discussionmentioning

confidence: 87%

The necessity revealed by COVID-19 pandemic: Paradigm shift of Iran's healthcare system

Mohammadpour

Delavari

Kavosi

et al. 2023

Front. Public Health

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“…[ 70 ] Nevertheless, this meta-analysis provides evidence on the risk of mortality associated with co-morbidities and this can help improve clinical decision-making in a world that is currently facing difficulty in the practice of evidence-based medicine. [ 71 ]…”

Section: Discussionmentioning

confidence: 99%

Prevalence of co-morbidities and its association with mortality in Indian patients with COVID-19: A meta-analysis

Jindal¹,

Gupta²,

Khan³

et al. 2022

Indian J Anaesth

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Background and Aims: Coronavirus disease 2019 (COVID 19) has spread to every corner of the world and has led to significant health consequences, especially in patients with co morbidities. This study aimed to estimate the prevalence of co morbidities among COVID 19 patients in the Indian population and their association with mortality. Methods: PubMed, Google Scholar, and World Health Organization website were searched for Indian studies on COVID 19 published from February 2020 up to 20 May 2021. English language publications from India, studies reporting epidemiological characteristics, prevalence of co morbidities and in hospital mortality were included in the meta analysis. Results: 34 studies were identified with a total of 23,034 patients. The pooled prevalence for co morbidities in COVID 19 patients was 18.1% [95% confidence interval (CI), 13.3 to 24.3%] for hypertension, 17.7% (95% CI, 12.2 to 25.1%) for diabetes, 7.9% (95% CI, 4.6 to 13.4%) for hypothyroidism and 7.7%(95% CI, 4.8 to 12. 1%) for cardiovascular diseases. For chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), cerebrovascular diseases, asthma, chronic liver disease, tuberculosis and cancer, the pooled prevalence was less than 4%. Additionally, the mortality risk was increased significantly in patients with CKD [odds ratio (OR) = 4.1], COPD (OR = 3.9), diabetes (OR = 3.7), cardiovascular diseases (OR = 4.07), tuberculosis (OR = 6.11), chronic liver disease (OR = 8.5), malignancy (OR = 1.89) and hypertension (OR = 2.9). Cerebrovascular diseases, hypothyroidism and asthma were not associated with increased mortality. Conclusion: Co-morbidities are more prevalent in COVID 19 hospitalised patients and the presence of co morbidities is associated with increased risk of mortality in Indian COVID 19 patients.

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“…This age-old challenge has worsened in the era of Covid-19. Another study has also con rmed that evidence-based medicine has been shaken during this pandemic and doctors' trust in it has been eroded due to disagreements in scienti c evidence and the publication of misleading scienti c articles about COVID-19 (42).…”

Section: Prevention Of Disruption In the Effective Provision Of Servi...mentioning

confidence: 99%

The necessity revealed by Covid-19: Paradigm shift of Iran's health system

Mohammadpour

Delavari

Kavosi

et al. 2022

Preprint

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Background: Covid-19 pandemic has brought drastic changes around the world, revealing the vulnerable aspects of health care systems. The purpose of this study is to explore the paradigm shift of Iranian health system and determine the aspects that need improvement, considering the experience of the recent pandemic. Method: This research is a qualitative and thematic analysis study that was conducted using the content analysis method. Nineteen semi-structured interviews were conducted with experts from Shiraz University of Medical Sciences and the data was saturated. To increase the accuracy and precision of the study, Guba and Lincoln's four criteria were used. And for data analysis, MAX QDA10 software and Goldsmith's five-step framework analysis were used. Result: The findings identified 8 main themes and 33 subthemes. The main themes included strengthening the electronic health infrastructure, research for evidence-based decision making, dedicated pandemic financing, prevention of disruption in the effective provision of services and drug therapy, enriching the authority of the Ministry of Health by focusing on interactions, recruiting, managing and empowering health human resources and paying attention to financial and non-financial incentives, reforming educational approaches in training students in medical universities, learning lessons from neglects. Conclusion: To be ready to respond to a possible future pandemic, bold steps must be taken to make fundamental changes in various aspects of the health system.

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Challenges for the practice of evidence-based medicine during COVID-19 pandemic (practice of evidence-based medicine in the new normal)

Cited by 6 publications

References 22 publications

The necessity revealed by COVID-19 pandemic: Paradigm shift of Iran's healthcare system

The necessity revealed by COVID-19 pandemic: Paradigm shift of Iran's healthcare system

Prevalence of co-morbidities and its association with mortality in Indian patients with COVID-19: A meta-analysis

The necessity revealed by Covid-19: Paradigm shift of Iran's health system

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