Evidence-based medicine—the view from Fiji

Lowe, Michael

doi:10.1016/s0140-6736(00)02743-4

Cited by 14 publications

(10 citation statements)

References 8 publications

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“…Doctors in developing countries have learned to tolerate uncertainty in their daily practice 6 and to work within the available resources for diagnosis and management. What can the developed world offer and how can international donors best assist in meeting the information needs of doctors and encourage them to practice evidence‐based medicine?…”

Section: Discussionmentioning

confidence: 99%

“…Evidence for these improvements is equivocal: a Cochrane systematic review concluded that audit and feedback can be effective in improving the performance of healthcare provision, and that although these improvements are small to moderate they are worthwhile 4,5 . Initiatives to disseminate medical knowledge in the developing world are under way: the Effective Healthcare in Developing Countries Project has started to address the issues of less developed countries and to ensure that their problems are included in the brief of the Cochrane collaboration 6 . In the field of reproductive health, the WHO Reproductive Health Library makes available a selection of relevant reviews in electronic format.…”

Section: Introductionmentioning

confidence: 99%

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Pathways to evidence‐based reproductive healthcare in developing countries

Geyoushi

Matthews

Stones

2003

BJOG

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Objective Developing country clinicians are aware of the discourse of evidence-based medicine but heavily constrained in their ability to access and apply new knowledge. This study aimed to obtain primary descriptive data about access to and application of reproductive health-related medical knowledge in developing countries. Design Qualitative study using semi-structured interviews.Setting India and Yemen.Sample Forty-one doctors working in obstetrics, gynaecology, general practice and family planning services.Methods Interviews were tape recorded and transcribed verbatim. A theory-driven approach was conducted to carry out thematic analysis. Main outcome measures Descriptions of experiences, attitudes and needs.Results Doctors felt the need to update their knowledge but this was not always achieved due to time and financial constraints. Alternative knowledge sources were described including the Internet, scientific meetings, medical family networks and speciality medical societies but access to these was limited by the expense of equipment, unfamiliarity with the technology and restricted advertisement of scientific meetings and conferences. Institutional hierarchy and conflict of generations were identified as barriers to change. Demoralisation was a common obstacle. On the positive side, involvement in medical education was a powerful driver for seeking new knowledge and applying research evidence to clinical practice. Conclusions Priorities are to identify needs specific to different countries and medical settings in the developing world, access for all to full text journals and educational activities that fully engage practitioners in the early stages of their careers. Clinical teachers are the nodal group with the strongest incentive to obtain and use new knowledge.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pathways to evidence‐based reproductive healthcare in developing countries

Geyoushi

Matthews

Stones

2003

BJOG

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“…Health care professionals in developing countries sometimes wonder whether their reliance on older, cheaper, “lower-tech” approaches has made their practice quite distinct from that of their colleagues in richer regions [6]. Yet the authors of systematic reviews seem, by and large, to prefer to take on the task of assessing the evidence for more recent (and generally more expensive) technologies.…”

Section: Reasons Why the Relevance Is Limitedmentioning

confidence: 99%

Is Evidence-Based Medicine Relevant to the Developing World?

Chinnock¹,

Siegfried²,

Clarke³

2005

PLoS Med

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“…While healthcare professionals in low-and middle-income countries (LMICs) should use evidence-based decisions in day-today patient care, implementing evidence-based medicine remains difficult. [4] Since the majority of studies are done in high-income countries for high-income countries relating to health conditions important to high-income countries, [5] their limited applicability and transferability to LMICs creates a knowledge vacuum in LMICs, including SA. [4] Research in the field of emergency care specifically related to LMICs is sparse.…”

mentioning

confidence: 99%

“…[4] Since the majority of studies are done in high-income countries for high-income countries relating to health conditions important to high-income countries, [5] their limited applicability and transferability to LMICs creates a knowledge vacuum in LMICs, including SA. [4] Research in the field of emergency care specifically related to LMICs is sparse. A single consensus study related to clinical research priorities, emergency centre management and administration exists, [6] but there are no lists or identified gaps for any aspects of emergency or acute care specific to SA.…”

mentioning

confidence: 99%

Emergency care research priorities in South Africap

2015

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Background. Emergency care research is rarely undertaken in low-and middle-income countries. A manageable 'road map' for research in South African (SA) emergency care is needed to address research gaps. Objective. To identify, collate and prioritise research topics from identified knowledge gaps in emergency care in SA. Methods. Seventy-six individuals were invited to participate in a modified Delphi study. Participants were requested to suggest important research topics before rating them. Consensus was achieved when >75% of participants strongly agreed or disagreed. Participants then ranked the agreed statements before selecting the most appropriate methodology relating to study design, funding and collaboration. Results. Three hundred and fifty topics were suggested by 31 participants. Topics were collated into 123 statements before participants rated them. Consensus was achieved for 39 statements. The highest-ranked priority in the prehospital group was to determine which prehospital interventions improve outcomes in critically ill patients. The competence of emergency care providers in performing common lifesaving skills was deemed the most important in clinical emergency care. Implementing and reviewing quality improvement systems scored the highest under general systems and safety management. Only 22 statements achieved consensus regarding study design. The National Department of Health was the preferred funding source, while private organisations and emergency care societies were identified as possible collaborative partners. Conclusion. This study provides expert consensus on priority research areas in emergency care in SA as a guide for emergency care providers to ensure evidence-based care that is relevant to the SA population.

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Evidence-based medicine—the view from Fiji

Cited by 14 publications

References 8 publications

Pathways to evidence‐based reproductive healthcare in developing countries

Pathways to evidence‐based reproductive healthcare in developing countries

Is Evidence-Based Medicine Relevant to the Developing World?

Emergency care research priorities in South Africap

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