Book contents
- Frontmatter
- Contents
- Foreword
- Contributors
- 1 Introducing evidence-based anaesthesia
- 2 How to define the questions
- 3 Developing a search strategy, locating studies and electronic databases
- 4 Retrieving the data
- 5 Critical appraisal and presentation of study details
- 6 Outcomes
- 7 The meta-analysis of a systematic review
- 8 Bias in systematic reviews: considerations when updating your knowledge
- 9 The Cochrane Collaboration and the Cochrane Anaesthesia Review Group
- 10 Integrating clinical practice and evidence: how to learn and teach evidence-based medicine
- 11 Involving patients and consumers in health care and decision-making processes: nothing about us without us
- 12 Evidence-based medicine in the Third World
- 13 Preoperative anaesthesia evaluation
- 14 Regional anaesthesia versus general anaesthesia
- 15 Fluid therapy
- 16 Antiemetics
- 17 Anaesthesia for day-case surgery
- 18 Obstetrical anaesthesia
- 19 Anaesthesia for major abdominal and urological surgery
- 20 Anaesthesia for paediatric surgery
- 21 Anaesthesia for eye, ENT and dental surgery
- 22 Anaesthesia for neurosurgery
- 23 Cardiothoracic anaesthesia and critical care
- 24 Postoperative pain therapy
- 25 Critical care medicine
- 26 Emergency medicine: cardiac arrest management, severe burns, near-drowning and multiple trauma
- Glossary of terms
- Index
12 - Evidence-based medicine in the Third World
Published online by Cambridge University Press: 05 September 2009
- Frontmatter
- Contents
- Foreword
- Contributors
- 1 Introducing evidence-based anaesthesia
- 2 How to define the questions
- 3 Developing a search strategy, locating studies and electronic databases
- 4 Retrieving the data
- 5 Critical appraisal and presentation of study details
- 6 Outcomes
- 7 The meta-analysis of a systematic review
- 8 Bias in systematic reviews: considerations when updating your knowledge
- 9 The Cochrane Collaboration and the Cochrane Anaesthesia Review Group
- 10 Integrating clinical practice and evidence: how to learn and teach evidence-based medicine
- 11 Involving patients and consumers in health care and decision-making processes: nothing about us without us
- 12 Evidence-based medicine in the Third World
- 13 Preoperative anaesthesia evaluation
- 14 Regional anaesthesia versus general anaesthesia
- 15 Fluid therapy
- 16 Antiemetics
- 17 Anaesthesia for day-case surgery
- 18 Obstetrical anaesthesia
- 19 Anaesthesia for major abdominal and urological surgery
- 20 Anaesthesia for paediatric surgery
- 21 Anaesthesia for eye, ENT and dental surgery
- 22 Anaesthesia for neurosurgery
- 23 Cardiothoracic anaesthesia and critical care
- 24 Postoperative pain therapy
- 25 Critical care medicine
- 26 Emergency medicine: cardiac arrest management, severe burns, near-drowning and multiple trauma
- Glossary of terms
- Index
Summary
This chapter focuses firstly on the differences between the West and the Third World, such as poverty, age of the population, disease burden, lack of skilled staff and equipment. Is simple equipment the best for resource-poor countries?
The importance of teaching evidence-based medicine to medical students is discussed, and the difficulties for the teachers of non-physician anaesthetists due to the lack of studies on the outcome of anaesthesia from non-physicians.
The Third World has huge research potential, but the major Western journals carry few studies from Third World workers. However some excellent work has been done especially when Western funding and expertise has joined hands with local workers. This is illustrated by the studies in mother to child HIV transmission carried out in Sub-Saharan Africa.
Introduction
A BBC reporter was interviewing a highly trained chest surgeon at a chest hospital in Afghanistan. There was no water supply, and the now unused theatre was filthy. The supply of drugs in the dispensary was minimal. The reporter did not understand what they were, but noticed that one box of tablets was 14 years old. The surgeon told how she had returned from the West to help rebuild her country, but the supposedly millions of dollars worth of aid never reached their hospital, so what use was she? At this point the surgeon was called to see a casualty, a road accident victim with a lung perforation.
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- Evidence-based Anaesthesia and Intensive Care , pp. 117 - 126Publisher: Cambridge University PressPrint publication year: 2006