LaGrone Lacey N, Fuhs Amy K, Egoavil Eduardo Huaman, Langdale Lorrie A, Fuangworawong Phupit, Hamasaki Jose Luis, Gyedu Adam, Mock Charles N
Harborview Injury Prevention and Research Center, University of Washington, Campus Box #356410, Seattle, WA, 98104, USA.
Indiana University School of Medicine, Indianapolis, IN, USA.
World J Surg. 2018 Feb;42(2):521-531. doi: 10.1007/s00268-017-4175-4.
We aimed to assess surgeons' access to and use of medical information, as well as their training and perceptions about evidence-based medicine (EBM), in order to identify priority areas for improvement.
An anonymous survey conducted among surgeons from the USA, Ghana, Peru, and Thailand examined access to, and use and perception of, medical literature.
Of 307 participants, 98% reported access to "OK" or "good" internet. Fifty-one percent reported that language was a barrier to accessing needed medical information; most frequently in Peru (73%) and Thailand (64%). Access to priced full-text journals was poorest in Peru, where 54% lacked access, followed by Ghana (42%) and Thailand (32%). US respondents scored highest on the EBM knowledge test (1.4, SD 0.8), followed by Thailand (1.3, SD 0.9), Ghana (1.1, SD 0.8), and Peru (0.9, SD 0.8) (p < 0.001). Adjusted analysis revealed Ghanaians and Peruvians spent 5% and 1% more on medical information, respectively, relative to country income, than persons from other countries (p < 0.01). After adjustment, employment in a large and/or urban hospital and history of EBM training were associated with better EBM test scores, while middle-income origin and public hospital employment were associated with worse scores (p < 0.05).
Language, access to priced full-text journals, and training are significant barriers to surgeons' practice of EBM globally. The way forward involves collaboration among surgical societies, publishers, hospital employers, and international policymakers in providing surgeons from all country income levels with the access and training necessary to interpret and apply medical information.
我们旨在评估外科医生获取和使用医学信息的情况，以及他们对循证医学（EBM）的培训和看法，以便确定需要改进的优先领域。
对来自美国、加纳、秘鲁和泰国的外科医生进行了一项匿名调查，调查内容包括医学文献的获取、使用和看法。
在307名参与者中，98%报告可以访问“良好”或“不错”的互联网。51%的人表示语言是获取所需医学信息的障碍；在秘鲁（73%）和泰国（64%）最为常见。在秘鲁，获取付费全文期刊的情况最差，54%的人无法获取，其次是加纳（42%）和泰国（32%）。美国受访者在循证医学知识测试中的得分最高（1.4，标准差0.8），其次是泰国（1.3，标准差0.9）、加纳（1.1，标准差0.8）和秘鲁（0.9，标准差0.8）（p<0.001）。经调整分析显示，相对于其他国家的人，加纳人和秘鲁人在医学信息上的花费分别比本国收入多5%和1%（p<0.01）。调整后，在大型和/或城市医院工作以及有循证医学培训经历与更好的循证医学测试成绩相关，而中等收入背景和在公立医院工作则与较差的成绩相关（p<0.05）。
语言、获取付费全文期刊的情况以及培训是全球外科医生实践循证医学的重大障碍。未来的方向包括外科协会、出版商、医院雇主和国际政策制定者之间的合作，为所有收入水平国家的外科医生提供解读和应用医学信息所需的途径和培训。
