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A Global Assessment of Access to and Use of Medical Information: The State of Evidence-Based Surgery

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A Correction to this article was published on 13 October 2017

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Abstract

Background

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.

Study design

An anonymous survey conducted among surgeons from the USA, Ghana, Peru, and Thailand examined access to, and use and perception of, medical literature.

Results

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).

Conclusion

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.

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Change history

  • 13 October 2017

    In the original article some funding information was inadvertently omitted. The complete funding information is as follows:

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Acknowledgements

The authors would like to express our sincere gratitude to Phil Caropreso and Tyler Hughes for assistance in data acquisition from the American College of Surgeons Rural Surgery group. We thank Dr. Indi Trehan for his expert consultation.

Funding

National Institutes of Health research training Grant #R25 TW009345.

Author information

Authors and Affiliations

  1. Harborview Injury Prevention and Research Center, University of Washington, Campus Box #356410, Seattle, WA, 98104, USA

    Lacey N. LaGrone, Lorrie A. Langdale, Phupit Fuangworawong & Charles N. Mock

  2. Indiana University School of Medicine, Indianapolis, IN, USA

    Amy K. Fuhs

  3. Hospital Nacional Guillermo Almenara, Lima, Peru

    Eduardo Huaman Egoavil

  4. Hospital Central de la Policía Nacional del Perú, Lima, Peru

    Jose Luis Hamasaki

  5. Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

    Adam Gyedu

Authors
  1. Lacey N. LaGrone
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  2. Amy K. Fuhs
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Correspondence to Lacey N. LaGrone.

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Additional information

A correction to this article is available online at https://doi.org/10.1007/s00268-017-4305-z.

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LaGrone, L.N., Fuhs, A.K., Egoavil, E.H. et al. A Global Assessment of Access to and Use of Medical Information: The State of Evidence-Based Surgery. World J Surg 42, 521–531 (2018). https://doi.org/10.1007/s00268-017-4175-4

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