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Year : 2015  |  Volume : 28  |  Issue : 2  |  Page : 152-153

Knowledge, attitude and practices of evidence-based medicine among Sudanese medical doctors

1 Director, Department of Research and Planning, Al-Ahsa Health Affairs, Al-Ahsa Province; Asssitant Professor, Faculty of Community Medicine, University of Khartoum, Sudan
2 Associate Professor, Department of Community Medicine and Public Health, Faculty of Medicine, Majmaah University, Al Hofuf, Saudi Arabia
3 Assistant Professor, Department of Community Medicine and Public Health, Faculty of Medicine, Academic City, Al Hofuf, Saudi Arabia
4 Department of Dermatology, King Faisal University, Al Hofuf, Saudi Arabia

Date of Web Publication21-Nov-2015

Correspondence Address:
Hatim Sid Ahmed
Director, Department of Research and Planning, Al.Ahsa Health Affairs, Al.Ahsa Province
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1357-6283.170128

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How to cite this article:
Ahmed HS, Mohamed EY, Abdalla SM, Madani KA, Kaliyadan F. Knowledge, attitude and practices of evidence-based medicine among Sudanese medical doctors. Educ Health 2015;28:152-3

How to cite this URL:
Ahmed HS, Mohamed EY, Abdalla SM, Madani KA, Kaliyadan F. Knowledge, attitude and practices of evidence-based medicine among Sudanese medical doctors. Educ Health [serial online] 2015 [cited 2022 Sep 30];28:152-3. Available from:

Dear Editor,

Evidence-based medicine (EBM) is defined as "the conscientious, explicit and judicious use of the best evidence in making decisions about the care of patients." For some countries, it is a new area of expertise that all physicians ideally need to acquire to become more current in their daily practices.[1] Most medical doctors working in Sudan have not received formal training in EBM.[2] There is evidence that most physicians base their medical decisions on their own previous experience, consultation with colleagues or simply use common sense, and there is consistent evidence of physicians' failure to translate research finding into clinical practice. Studies addressing medical doctors' attitudes toward EBM are lacking in the Arab world and in developing countries in general. Sudan is not an exception, and there is a lack of information about the knowledge, attitudes and practices of its medical doctors of various specialties regarding EBM.[2]

Ours was a descriptive, facility-based study conducted in Khartoum Teaching Hospital, Sudan, which is the largest referral hospital in the country. The hospital, which has more than 780 beds and 300 physicians, represents one of the main health professions training institutions in the country. The study was carried out in the period 2008–2009.

The study target population included all physicians working in the hospital. A total of 110 medical doctors were selected using a convenience sampling technique; we approached physicians well known in the hospital and easily accessible to the primary author. Data was collected by using a self-administered questionnaire, adapted from one developed by Al-Ansary et al., and used in Saudi Arabia with a study population similar to ours in terms of language and culture.[3] A Likert scale-based questionnaire was used to measure physicians' knowledge, attitudes and practice regarding EBM. Subject's knowledge of EBM terms and concepts was assessed against standard definitions of these terms. The SPSS for windows software version 16 (SPSS, Chicago, Illinois, USA) was employed to analyze the data. Ethical approval was obtained from the ethical committee, the Federal Ministry of Health and all respondents gave their informed consent.

Completed questionnaires were returned by 80 subjects, giving a response rate of 72%. Most respondents were male (52.5%) and most were house officers (interns; 46.3%), followed by registrars (post-graduate students; 26.3%), specialists (18.3%) and consultants (8.8%).

Doctors had varying level of knowledge about the several queried EBM terms. The meaning of risk factors was known by 67 (83%) respondents, and the definitions of relative risk, absolute risk and sensitivity were known by 56 (70%). Specificity and clinical effectiveness was known by 49 respondents (61%) and systematic review by 50 (62%), a total of 62 (77.5%) respondents agreed that quality of health care improved by practicing EBM.

Self-identified barriers to implementing EBM were a lack of facilities (88.8%), lack of time (65%), lack of skills (57.6%) and lack of interest (22.6%), as shown in [Table 1].
Table 1: Barriers of implementing EBM (n=80)

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Our study shows that while physicians in Sudan generally have a positive attitude toward EBM, their knowledge about it and its practical implementation were poor.

These Sudanese physicians in its leading training hospital had variable understanding of EBM's technical terms, ranging from good (83.8%) to poor (21.3%). These were similar to findings for physicians in the Riyadh region of Saudi Arabia.[3] Sudanese physicians' positive attitudes toward EBM is also similar to that of consultant physicians in western Saudi Arabia.[4] Studies in other countries have also similarly found that a generally positive attitude among health care workers toward EBM did not necessarily translate into actual EBM practice.[5]

Regular practice of EBM was found to be below (56.3%) in this study, perhaps due to the barriers perceived by these physicians, like, including a lack of facilities, time and skills.

The major limitation of the study was its small sample size, which makes generalization of its findings to other physicians in Sudan difficult. The study also had a limitation of being essentially a cross-sectional survey. A stronger alternative would have been to conduct an interventional study and assess its effectiveness based on Kirkpatrick's model.[6]

The results of this study indicate that Sudanese physicians have a limited knowledge of some key aspects of EBM, but a positive attitude toward the concept and limited experience in the practice of EBM.

  Acknowledgments Top

The authors would like to thank the IT department in Khartoum Teaching Hospital for their support in data collection and to the manager of Khartoum Teaching Hospital and to the physicians for their active participation in the study.

  References Top

Rosenberg W, Donald A. Evidence based medicine: An approach to clinical problem-solving. BMJ 1995;310:1122-6.  Back to cited text no. 1
Zeidan AZ, Behairy MM. Knowledge, attitudes and practices of evidence based medicine among residence doctors in Sudan. Sudan J Med Sci 2010;3:2007-12.  Back to cited text no. 2
Al-Ansary LA, Khoja TA. The place of evidence-based medicine among primary health care physicians in Riyadh region, Saudi Arabia. Fam Pract 2002;19:537-42.  Back to cited text no. 3
Al-Omari FK, Al-Asmary SM. Attitude, awareness and practice of evidence based medicine among consultant physicians in Western region of Saudi Arabia. Saudi Med J 2006;27:1887-93.  Back to cited text no. 4
Amin Z, Aw M, Soo R, Ooi S, Sivaraman P, Yeo JF, et al. Attitudes, practice and educational preferences towards evidence – Based medicine among physicians in a large teaching hospital. Med Educ Online 2007;12:6.  Back to cited text no. 5
Yardley S, Dornan T. Kirkpatrick's levels and education 'evidence'. Med Educ 2012;46:97-106.  Back to cited text no. 6


  [Table 1]

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