How To Analyse Your Research Data? Illustrations with Hands-On Exercises Using SPSS

Statistical analysis for a quantitative study is often perceived to be the most difficult step by a novice researcher. The objective of this paper is to provide step by step guides to analyse quantitative data. A common research topic on diabetes is used to illustrate the approach in data analysis. There are several statistical software packages available to assist researchers in data analysis. SPSS (Statistical Package for Social Sciences) software is applied in the hands-on example. The dataset about blood glucose control in diabetic patients and a trial version of SPSS are made available online. Having studied the paper and practiced the hands-on example, a reader is expected to be able to apply and interpret appropriate statistical tests for his/ her research

Nap patterns of children in kindergartens and childcare transit facility: a study in northern Peninsular Malaysia

Objective: The purpose of this study was to compare the duration of sleep and nap patterns between children in private kindergartens and those in a tabika-transit facility, in Malaysia. Methods: The sleep duration of children aged 3-6, who attended either a kindergarten or a childcare transit facility (tabika-transit in Malay) was investigated. Observational sleeping records were maintained for 24 hours, over 14 consecutive days. A self-administered questionnaire for caregivers investigated the children’s lifestyles. Naps were optional at kindergartens but mandatory at the tabika-transit. Results: Of 35 participating children, data from 33 were analyzed. All respondents belonged to the Malay ethnicity, with 16 boys (48.5%) and 17 girls (51.5%). The average age of the children was 5.4 years; 11 of them were from kindergartens and 22 from a tabika-transit. The children slept longer and woke up later on weekends than on weekdays. There was a significant difference in the naptaking rate between the two groups; it was 100% in the tabika-transit, and 30% in the kindergartens during weekdays. However, on weekends, 19 of 22 tabika- transit children did not nap on any of the days (86.4%). The kindergarten group’s naps showed no outstanding differences between weekdays and weekends. Concerning the bedtime and wake-up times, no differences were found between the two groups. Discussion: During weekdays, all children in the tabika-transit took naps, whereas one-third of them did in the kindergartens. Larger study is needed to assess how this mandatory napping style affects children’s lifestyle and development

Prevalence of white coat hypertension in adult primary care attenders

BackgroundWhite coat hypertension (WCH) is common but such data is lacking in Malaysia. AimsTo determine the prevalence of WCH and its associated factors among healthy adults in the Malaysian primary care setting. Methods This was a cross-sectional study conducted from January to June 2014 in 5 primary care clinics in Negeri Sembilan, Malaysia. Previously healthy adult who found to have persistently elevated BP fulfilling all the inclusion and exclusion criteria of our study at clinic were recruited. The validated BP set Omron HEM7200 was used for home BP monitoring in making the diagnosis of WCH. Patients were guided to do home BP monitoring. Results A total of 105 subjects completed the study, with a response rate of 92.1 per cent. The prevalence of WCH among Malaysian primary care attenders was 52.4 per cent. There was no correlation found between WCH and socio-demographic variables. ConclusionMore WCH studies using ambulatory blood pressure monitoring with larger sample size are needed for Malaysian primary care setting. Accurate diagnosis of hypertension could have saved money on the unnecessary anti-hypertensive agents

Self-perceived competence correlates poorly with objectively measured competence in Evidence Based Medicine among medical students

<p>Abstract</p> <p>Background</p> <p>Previous studies report various degrees of agreement between self-perceived competence and objectively measured competence in medical students. There is still a paucity of evidence on how the two correlate in the field of Evidence Based Medicine (EBM). We undertook a cross-sectional study to evaluate the self-perceived competence in EBM of senior medical students in Malaysia, and assessed its correlation to their objectively measured competence in EBM.</p> <p>Methods</p> <p>We recruited a group of medical students in their final six months of training between March and August 2006. The students were receiving a clinically-integrated EBM training program within their curriculum. We evaluated the students' self-perceived competence in two EBM domains ("searching for evidence" and "appraising the evidence") by piloting a questionnaire containing 16 relevant items, and objectively assessed their competence in EBM using an adapted version of the Fresno test, a validated tool. We correlated the matching components between our questionnaire and the Fresno test using Pearson's product-moment correlation.</p> <p>Results</p> <p>Forty-five out of 72 students in the cohort (62.5%) participated by completing the questionnaire and the adapted Fresno test concurrently. In general, our students perceived themselves as moderately competent in most items of the questionnaire. They rated themselves on average 6.34 out of 10 (63.4%) in "searching" and 44.41 out of 57 (77.9%) in "appraising". They scored on average 26.15 out of 60 (43.6%) in the "searching" domain and 57.02 out of 116 (49.2%) in the "appraising" domain in the Fresno test. The correlations between the students' self-rating and their performance in the Fresno test were poor in both the "searching" domain (r = 0.13, p = 0.4) and the "appraising" domain (r = 0.24, p = 0.1).</p> <p>Conclusions</p> <p>This study provides supporting evidence that at the undergraduate level, self-perceived competence in EBM, as measured using our questionnaire, does not correlate well with objectively assessed EBM competence measured using the adapted Fresno test.</p> <p>Study registration</p> <p>International Medical University, Malaysia, research ID: IMU 110/06</p

Interpreting systematic reviews: are we ready to make our own conclusions? A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Independent evaluation of clinical evidence is advocated in evidence-based medicine (EBM). However, authors' conclusions are often appealing for readers who look for quick messages. We assessed how well a group of Malaysian hospital practitioners and medical students derived their own conclusions from systematic reviews (SRs) and to what extent these were influenced by their prior beliefs and the direction of the study results.</p> <p>Methods</p> <p>We conducted two cross-sectional studies: one with hospital practitioners (<it>n </it>= 150) attending an EBM course in June 2008 in a tertiary hospital and one with final-year medical students (<it>n </it>= 35) in November 2008. We showed our participants four Cochrane SR abstracts without the authors' conclusions. For each article, the participants chose a conclusion from among six options comprising different combinations of the direction of effect and the strength of the evidence. We predetermined the single option that best reflected the actual authors' conclusions and labelled this as our best conclusion. We compared the participants' choices with our predetermined best conclusions. Two chosen reviews demonstrated that the intervention was beneficial ("positive"), and two others did not ("negative"). We also asked the participants their prior beliefs about the intervention.</p> <p>Results</p> <p>Overall, 60.3% correctly identified the direction of effect, and 30.1% chose the best conclusions, having identified both the direction of effect and the strength of evidence. More students (48.2%) than practitioners (22.2%) chose the best conclusions (<it>P </it>< 0.001). Fewer than one-half (47%) correctly identified the direction of effect against their prior beliefs. "Positive" SRs were more likely than "negative" SRs to change the participants' beliefs about the effect of the intervention (relative risk (RR) 1.8, 95% confidence interval 1.3 to 2.6) and "convert" those who were previously unsure by making them choose the appropriate direction of effect (RR 1.9, 95% confidence interval 1.3 to 2.8).</p> <p>Conclusions</p> <p>The majority of our participants could not generate appropriate conclusions from SRs independently. Judicious direction from the authors' conclusions still appears crucial to guiding our health care practitioners in identifying appropriate messages from research. Authors, editors and reviewers should ensure that the conclusions of a paper accurately reflect the results. Similar studies should be conducted in other settings where awareness and application of EBM are different.</p> <p>Please see Commentary: <url>http://www.biomedcentral.com/1741-7015/9/31/</url>.</p

The place and barriers of evidence based practice: knowledge and perceptions of medical, nursing and allied health practitioners in malaysia

<p>Abstract</p> <p>Background</p> <p>Despite a recent increase in activities to promote evidence-based practice (EBP), it was unclear how Malaysian hospital practitioners received this new approach in medicine. This study examines their confidence and perceptions on EBP.</p> <p>Findings</p> <p>We conducted cross-sectional surveys using a self-administered questionnaire during two EBP training courses in two Malaysian hospitals in January and June 2007. Our subjects (n = 144) were doctors and nursing and allied health staff (NAH) participating in the EBP courses. Our questionnaire covered three domains: confidence and understanding (six items), attitude (five items) and barriers to practice (four items). We presented simple descriptive statistics, including the sum ratings and the proportions with different responses for each item, and compared different groups using Mann-Whitney U test for scaled ratings and Chi-square test for dichotomous responses.</p> <p>Ninety-two doctors and 52 NAH staff completed the surveys. Overall, doctors expressed slightly higher confidence on EBP compared to NAH staff. Out of a maximum sum rating of 27 over six items, doctors reported an average of 18.3 (SD 3.2) and NAH staff reported an average of 16.0 (SD 3.4), p = 0.002. Doctors were also more positive in their views on EBP. For example, 67.4% of doctors disagreed, but 61% of NAH staff agreed that "the importance of EBP in patient care is exaggerated", and 79.3% of doctors disagreed, but 46.2% of NAH staff agreed that "EBP is too tedious and impractical". Similar responses were observed for other items in the domain.</p> <p>Doctors and NAH staff shared similar concerns on barriers to evidence-based practice. The highest proportions considered poor facilities to access evidence a barrier (76% of doctors and 90% of NAH), followed by poor awareness of evidence (62% of doctors and 70% of NAH) and time constraints (63% of doctors and 68% of NAH), p = 0.09 for the combined rating of four items in the domain.</p> <p>Conclusions</p> <p>The findings of our survey suggest a need for greater efforts in promoting EBP among Malaysian hospital practitioners especially for NAH staff. From the responses based on the barriers to EBP, improving facilities for accessing evidence and promoting more user-friendly resources to address time constraints appear to be the priorities.</p

Antibiotic prescribing for upper respiratory tract infections in the Asia-Pacific region: A brief review

This review highlights the high prevalence of antibiotic use for upper respiratory tract infections (URTIs) in a larger part of the Asia-Pacific region. Since URTIs are one of the common reasons for primary care consultations in this region, inappropriate use of antibiotic in both quantity and drug choice has greatly influenced the development of antibiotic resistance. Notwithstanding the paucity of Asia-Pacific data on the above issues, the available information suggests urgent actions needed to be taken to promote judicious antibiotic use at the point-of-care through a multipronged approach targeting the patients/consumers (or parents), healthcare providers and health care systems

Do statins adversely affect the HbA1c of diabetic patients?

This paper discusses the adverse effect of statins on the HbA1c levels of diabetic patients. Studies have shown that statins may slightly worsen the HbA1c level. The effects vary depending on the type of statins, the dosage and the duration of therapy. However, it has been confirmed that statin use has benefits that outweigh its harms. Therefore, a diabetic patient should be given advice on the need for appropriate lifestyle changes and the importance of continuing the statins

http://e-mfp.org/pdf/2013v8n3/IgM-dengue-serology.pdf

A 21-year old medical student consults the doctor for a fever that started 3 days ago. The fever was high grade and associated with generalised body aches. There was no gum bleeding. He mentioned that mosquito fogging was conducted in his neighbourhood recently