Analysis Of Articles on Evidence-Based Medicine

The aim of this study is to conduct a bibliometric analysis of articles on evidence-based medicine. Using Bibliometrix and VOSviwer software, the most efficient author, country, organization, and journals were identified. Web of Science articles between the years of 1975-2019 were downloaded with a search strategy and analyzed with Bibliometrix and VOSviwer software. It has been observed that evidence-based medicine articles were grouped under three main clusters (Management and Decision Support, Drug and Experiment and Measurment). The first three countries that have the highest international collaboration rate are Switzerland, New Zealand, and Sweden. The first five countries regarding publication numbers are the USA, United Kingdom, Canada, Australia, and Germany. While Khan and Green have the highest grade in h and g index; Baglı, Castagnetti and Fossum have the highest grade in m index. Guyatt is the author who has the highest number of citations whereas Phillips is the one who has the most publications. While, on one hand, evidence-based medicine extends its function in illness and drug treatments, on the other hand, it is used as policy input to improve the education, curriculum, and the health system. Policy-makers, decision-makers, educators, and researchers can develop strategies according to the findings identified above.

Impact and paybacks of biomedical research findings in Malaysia 2005–2015

Background: Impact in research encompasses health, economic, and cultural benefits beyond adding to the knowledge base. Funders are under immense pressure to be accountable for the paybacks from funded research.Aims and objectives: The aim of this study was to look into the impact of funded biomedical research between the years 2005 and 2015 in Malaysia from the aspects of knowledge production, research targeting and capacity building, as well as health system policy and decision making.Methods: This study employed a convergent parallel mixed-methods research design. Biomedical projects related to breast cancer, coronary heart disease, and dengue, funded by the Ministry of Health (MOH), Ministry of Higher Education (MOHE), and Ministry of Science, Technology, and Innovation (MOSTI) between the years 2005 and 2015, were included.Findings: From the questionnaire responses (n=58), on average each funded project managed to produce two outputs and one higher degree student. More than half (61.4%) of the funded projects led to subsequent future research. However, low citations in systematic reviews (10.3%), health policies (6.9%), and clinical practice guidelines (5.2%) were reported. In-depth interviews with the key opinion leaders also saw that most of the local research findings were found to be irrelevant to be adopted into policies by the policymakers.Discussion and conclusions: Paybacks on knowledge production as well as research targeting and capacity building had been achieved, but impact on health system policy and decision making had not been well attained, due to the lack of relevant research findings needed by the policymakers.<br />Key messages<br /><ul><li>Payback on knowledge production was achieved, as there had been a lot of new knowledge generated as captured in academic publications, conference proceedings, policy briefs, technical reports, and research highlights, which is important to advance the frontiers of knowledge.</li><br /><li>Payback on research targeting was achieved, with the current research leading to future study with identification of the knowledge gap and generation of new ideas for new research.</li><br /><li>Payback on capacity building was achieved with the training of researchers, building up research capacity and competencies, production of MSc and PhD graduates, promotion of lecturers, and development of new partnerships and networks.</li><br /><li>Impact on health system policy and decision making was not well attained. There had been a lack of relevant research data and findings being incorporated into policymaking, due to the basic and fundamental nature of most of the funded biomedical research in Malaysia.</li></ul>

What drives absenteeism among doctors in rural primary healthcare setting in Bangladesh? A qualitative exploration

Absenteeism', among physicians, has been a long-standing issue in Bangladesh, but little is known about the intersection between political structures, health system policy and shortages that drives provider behaviour. Using an in-depth interview guideline 30 interviews were conducted with physicians working in rural and urban facilities through purposive sampling. Data were analysed in Atlas ti and synthesized following Gales framework method. Senior doctors were usually absent due to the lack of opportunities to specialise/dual/private practice in rural facilities. Absence of career progression (especially among junior physicians), inadequate and unsafe living and workplace arrangements, absence of transport facilities, lack of community understanding and ownership, non-cooperation from colleagues and absence of incentives or recognition de-motivated physicians to stay at their posts in rural facilities. Incidences of abuse (verbal/physical) by local community were common with female physicians particularly vulnerable. Disciplinary actions against absenteeism were unclear, and many respondents were unaware of these. Almost all of the doctors wished to move out of rural areas. Those who were successful, used their social and political networks and the payments of bribes to facilitate movement into urban settings. Doctors who did not have access to financial resources or to these networks failed to move out of rural areas and one left the profession.

Health-related publications on people living in fragile states in the alert zone: a bibliometric analysis

Background: Fragile states pose a global challenge. Assessing health research activity on people living in these states can help identify neglected health domains in fragile settings. The objective of the current study was to assess and describe health research activity on people living in fragile states in the alert zone. Method: A bibliometric method was applied using SciVerse Scopus. Research articles published on people in fragile states in the alert zone were retrieved and analyzed. The Fragile State Index (FSI) score was used for selection of states in the alert zone. The analysis was limited to one year; 2018. Results: The search query found 2299 research articles giving an average of 2 research articles per one million population per year in the selected fragile states. The number of research articles per one million population was not significantly correlated (p=0.053; r= - 0.349) with FSI scores. However, it was significantly correlated with the extent of international research collaboration (P<0.01, r=065). Research on communicable diseases was the largest research domain (763 articles; 33.2%) followed by maternal/women’s health (430 articles; 18.7%), non-communicable diseases (291 articles; 12.7%), health system/policy (271 articles; 11.8%) and psychosocial and mental health (89; 3.9%). There were three research themes in the research domain of infectious diseases: HIV/AIDS; water-borne infectious diseases; and miscellaneous infectious diseases such as tuberculosis and malaria. The top ten cited articles were mainly on infectious diseases, particularly on malaria and Lassa fever. Of all the retrieved documents, 727 (31.6%) research articles appeared in national/regional journals while the remaining appeared in international journals. The World Health organization was the most active funding organization for research on fragile states. Top ten active institutions were mainly based in fragile states with the lowest FSI score, specifically Ethiopia, Uganda, Nigeria, and Pakistan. Conclusion: Research on fragile states was relatively low. Research on mental health and health system/policy should be encouraged. Collaboration and funding might help academic institutions in fragile states to make health problems in these countries more visible

Health-related publications on fragile states in the alert zone: a bibliometric analysis

Background Vulnerable and fragile settings is global health challenge. Assessing health research activity can help identify neglected health domains in fragile settings. The objective of the current study was to assess and describe health research activity on fragile states in the alert zone. Method A bibliometric method was applied using SciVerse Scopus. Research articles published on fragile states in the alert zone were retrieved and analyzed. The Fragile State Index (FSI) score was used for selection of states in the alert zone. The analysis was limited to one year; 2018. Results The search query found 2299 research articles giving an average of 2 research articles per one million people per year in the selected fragile states. The number of research articles per one million population was not significantly correlated (p=0.053; r= - 0.349) with FSI scores. However, it was significantly correlated with the extent of international research collaboration (P<0.01, r=065). Research on communicable diseases was the largest research domain (763 articles; 33.2%) followed by maternal/women’s health (430 articles; 18.7%), non-communicable diseases (291 articles; 12.7%), health system/policy (271 articles; 11.8%) and psychosocial and mental health (89; 3.9%). The top ten cited articles were mainly on infectious diseases, particularly on malaria and Lassa fever. Of all the retrieved documents, 727 (31.6%) research articles appeared in national/regional journals while the remaining appeared in international journals. The World Health organization was the most active funding organization for research on fragile states. Top ten active institutions were mainly based in fragile states with the lowest FSI score, specifically Ethiopia, Uganda, Nigeria, and Pakistan. Conclusion Research on fragile states was relatively low. Research on mental health and health system/policy should be encouraged. Collaboration and funding might help academic institutions in fragile states to make health problems in these countries more visible

Cognitive impairment in aging physicians

Aging physicians are at a higher risk of cognitive impairment, undermining patient safety and unraveling physicians' careers. Neurologists, occupational health physicians, and psychiatrists will participate in both health system policy decisions and individual patient evaluations. We address cognitive impairment in aging physicians and attendant risks and benefits. If significant cognitive impairment is found after an appropriate evaluation, precautions to confidentially support physicians' practicing safely for as long as possible should be instituted. Understanding that there is heterogeneity and variability in the course of cognitive disorders is crucial to supporting cognitively impaired, practicing physicians. Physicians who are no longer able to practice clinically have other meaningful options.