handsearching of 2 medical journals of Bahrain for reports of randomized controlled trials

To identify reports of randomized trials by handsearching 2 Bahrain medical journals, which are indexed in the biomedical database EMBASE and to determine any added value of the handsearching by comparing the reports found by handsearching with what would have been found by searching EMBASE to examine [i] the precision and sensitivity of the EMBASE index term Randomized Controlled Trial [RCT] and [ii] The Cochrane Collaboration's systematic electronic search of EMBASE [which uses 4 index terms and 9 free-text terms]. All issues of the Bahrain Medical Bulletin [BMB] [1979-2004] and the Journal of the Bahrain Medical Society [JBMS] [1989-2004] were handsearched in February 2005 for reports of RCTs or Controlled Clinical Trials [CCTs] according to Cochrane eligibility criteria. Out of 395 articles in BMB we found reports of 12 RCTs and 4 CCTs. Distribution by country of corresponding author: Jordan [4 RCTs, one CCT], Bahrain [one RCT, one CCT], India [3 RCTs, one CCT], Kuwait [one CCT], Saudi Arabia [2 RCTs], USA/Bahrain [one RCT], and Oman [one RCT]; and by specialty: Anesthesia [8], Surgery [1] Pediatrics [1], Radiotherapy [1], Community Medicine [1], Sports Medicine [1], Obstetrics/Gynecology [3]. The Journal of the Bahrain Medical Society included reports of 14 RCTs and 3 CCTs, out of 97 articles. Distribution by country of corresponding author: Jordan [9 RCTs, 2 CCTs], Bahrain [3 RCTs], Egypt [one RCT], Kuwait [one RCT], and Saudi Arabia [one RCT]; and by specialty: Anesthesia [7], General Surgery [3], Obstetrics/Gynecology [1], Radiotherapy [1], Pediatrics [1], Orthopaedic Surgery [1], Education [1] Ear Nose and Throat [1] Ophthalmology [1]. Overall, of the 33 reports of trials found by handsearching I both journals, only 23 were included in EMBASE of 1 which only 6 had been indexed with the term RCT. Off the 23 reports of trials included in EMBASE, 16 had been identified in the Collaboration's systematic search of EMBASE. Two reports of trials could have been retrieved by this search but there was insufficient information in the title and abstract to code these as trials. The EMBASE records for the remaining 5 reports of trials did not contain terms currently used by The Cochrane Collaboration to identify reports of randomized trials in this database. The handsearching of these journals will help minimize publication bias by locating randomized trials not previously identified and, through their inclusion in the Cochrane Central Register of Controlled Trials [CENTRAL] in The Cochrane Library, will ensure reports of randomized trials will not remain 'buried' through indexing bias

cochrane systematic review finds no significant difference in outcome or risk of postoperative complications between day care and in-patient cataract surgery

This review was conducted to determine reliable evidence regarding the safety, feasibility, effectiveness, and cost-effectiveness of cataract extraction performed as a day care versus in-patient procedure. The search to identify randomized controlled trials comparing day care and in-patient surgery for age-related cataract included the Cochrane Eyes and Vision Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and LILACS Latin American and Caribbean Literature on Health Sciences. Assessment of methodological quality was based on criteria defined by the Cochrane Collaboration. The primary outcome was the achievement of a satisfactory visual acuity 6 weeks after operation. Two trials, involving a total of 1284 people, are included. One trial reported statistically significant differences in early postoperative complication rates in the day care group, which had no clinical relevance to visual outcomes 4 months postoperatively. Mean change in visual acuity Snellen lines of the operated eye 4 months postoperatively was 4.1 standard deviation SD 2.3 for the day care group and 4.1 SD 2.2 for the in-patient group. Costs were 20% more for the in-patient group attributable to higher costs for overnight stay

study of knowledge and attitudes towards the use of evidence-based medicine among primary health care physicians in Bahrain

A study of perceptions and attitudes towards the use of evidence-based medicine [EBM] among family physicians in Bahrain. A systematically developed, anonymous, self administered 13 item questionnaire was mailed to 124 Bahraini family physicians in the Ministry of Health, Bahrain between January and April 2004. The response rate was 65%. Data were analyzed using the Statistical Package for Social Sciences [Windows version 11.00]. The respondents [n=81] were mainly female [65.4%] with a mean age of 40 [SD 7.7] years, with 12.7 [SD 8.3] years since graduation. Forty-two percent had attended EBM workshops and 61% claimed to use EBM in their practice. Those who had attended a workshop were more likely to assert that they were practicing EBM [82% versus 47%; p=0.001]. Less than 10% selected patient s choice as a component of EBM. The 81.5% of respondents agreed their patients were willing to participate in decision making but 50% felt that only 10-25% of their patients were capable. No time [53.1%] and no ready access to resources [73.5%] were the most cited barriers, 32% of respondents agreed that EBM is not applicable to their culture. Most family physicians in Bahrain claimed to use EBM in their practice, particularly if they had attended an EBM workshop. However, most of them did not consider patients values as a component of EBM. A substantial minority considered that EBM is inapplicable to their culture