RESUMO
OBJECTIVE: To investigate the information-use behavior of Thai clinicians in the evidence-based medicine (EBM) process. MATERIAL AND METHOD: Based on the survey research, 198 questionnaires were sent to EBM clinicians working in public hospitals in Thailand. The data were analyzed by mean, percentage, and factor analysis. RESULTS: One hundred and fifty-seven questionnaires (79.3%) were returned. The results revealed that 52.9% of the clinicians used EBM process in clinical practice at a high level and 41.4% at a moderate level. Most respondents (91.7%) used information for supporting their teaching and learning process as well as for professional self-development. About two-third used information for supporting their clinical decision. The types of information that the clinicians used in high percentage were research articles from medical journals (89.7%), systematic reviews (83.4%), textbooks, and reference books in the medical field (80.8%). The information resources that were often used including Internet resources (84.1%), hospital or medical school libraries (73.7%), expert consultation (59.8%), and the medical record unit (41.9%). Most of the respondents (89.7%) used PubMed, search engine (85.6%) and Cochrane Library (56.4%) as the tools for accessing information. Most respondents frequently had accessed to information 2-3 days a week and 93.7% of them preferred to access information resources via the Internet by themselves at their office or home. For searching strategies, most clinicians used key words (95%). In the present study, 20 variables were designed to test the factors correlated with the clinicians' information use. The results showed that the six variables (information use, EBM use, experience, organization, competency, and educational background) were significantly correlated with information used by clinicians in EBM process. CONCLUSION: Most Thai clinicians in the present study used EBM process. They regularly searched information by themselves with simple strategy. The results of the present study could be used for planning to improve the quality of clinicians in EBM practice. Since information use is important in using EBM, all hospitals should have adequate facilities to provide medical information for clinical practice. Relevant data from the present study may be useful for planning the use of EBM process and to further researches.
RESUMO
OBJECTIVE: Study the association between microalbuminuria and diabetic retinopathy in type 2 diabetic patients. MATERIAL AND METHOD: A cross-sectional analytic study of 1,111 cases with type 2 diabetic patients recruited from seven public hospitals, between June and December 2006 was performed RESULT: Two hundred eighty six subjects (79 males and 207 females) with urine dipsticks for microalbuminuria detection tested positive at least 2 of the 3 morning urine samples within 6 months. They were divided into 2 equal groups, micro- and normoalbuminuria based on quantity of albumin. Indirect ophthalmologic examination of all subjects' eyes for diabetic retinopathy was performed by ophthalmologists (retinal specialists). The present study showed that the proportion of diabetic retinopathy was 19.6% (28/143) and 12.6% (18/ 143) in micro- and normoalbuminuric groups, respectively. The difference of proportion between the groups was 7% but was statistically not significant (p = 0.108). CONCLUSION: Microalbuminuria detected using urine dipstick was not cross-sectionaly associated with diabetic retinopathy in type 2 diabetic patients.