Evidence map›Paper›PMID 31399450›Full record

ArticleBMJ open2019

Better evidence: prospective cohort study assessing the utility of an evidence-based clinical resource at the University of Rwanda.

Yannis K Valtis, Julie D Rosenberg, Keri Wachter, Rodrick Kisenge, Fredirick Mashili, Rehema Chande Mallya, Timothy David Walker, J Damascene Kabakambira, Abahuje Egide, Blaise Ntacyabukura and 1 more

Abstract read
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yannis K ValtisDepartment of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.ORCID 0000-0001-8927-8006
Julie D RosenbergDepartment of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Keri WachterGlobal Health Delivery Project, Harvard University, Boston, MA, USA.
Rodrick KisengeMuhimbili University of Health and Allied Sciences, Dar es Salaam, Dar es Salaam, Tanzania, United Republic of.
Fredirick MashiliMuhimbili University of Health and Allied Sciences, Dar es Salaam, Dar es Salaam, Tanzania, United Republic of.ORCID 0000-0002-5306-6703
Rehema Chande MallyaMuhimbili University of Health and Allied Sciences, Dar es Salaam, Dar es Salaam, Tanzania, United Republic of.
Timothy David WalkerCollege of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.ORCID 0000-0001-7034-1327
J Damascene KabakambiraCollege of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Abahuje EgideCollege of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Blaise NtacyabukuraCollege of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Rebecca WeintraubBetter Evidence, Ariadne Labs, Boston, Massachusetts, USA.

Funding

Harvard Clinical and Translational Science CenterUL1TR001102 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2013 to 2017
$106.2M
NCATS NIH HHS UL1 TR001102
6 · The paper itself

Abstract

objectiveEvidence-based clinical resources (EBCRs) have the potential to improve diagnostic and therapeutic accuracy. The majority of US teaching medical institutions have incorporated them into clinical training. Many EBCRs are subscription based, and their cost is prohibitive for most clinicians and trainees in low-income and middle-income countries. We sought to determine the utility of EBCRs in an East African medical school.

settingThe University of Rwanda (UR), a medical school located in East Africa.

participantsMedical students and faculty members at UR.

interventionsWe offered medical students and faculty at UR free access to UpToDate, a leading EBCR and conducted a cohort study to assess its uptake and usage. Students completed two surveys on their study habits and gave us permission to access their activity on UpToDate and their grades.

resultsOf the 980 medical students invited to enrol over 2 years, 547 did (56%). Of eligible final year students, 88% enrolled. At baseline, 92% of students reported ownership of an internet-capable device, and the majority indicated using free online resources frequently for medical education. Enrolled final year students viewed, on average, 1.24 topics per day and continued to use UpToDate frequently after graduation from medical school. Graduating class exam performance was better after introduction of UpToDate than in previous years.

conclusionsRemoval of the cost barrier was sufficient to generate high uptake of a leading EBCR by senior medical students and habituate them to continued usage after graduation.

Indexed as

Health ResourcesSchools, MedicalCohort StudiesEducation, MedicalEvidence-Based MedicineHumansProspective StudiesRwandaEBCR, global medical educationgeneral medicine (see internal medicine)global healthinformation technology

Identifiers

PMID31399450
PMCPMC6701685

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.