Letter to the Editor
VOWELS: A communication framework for disclosing medical errors in medical oncology and palliative care
Dear Editor,
Recognising the impact of medical errors on patients and the doctor-patient relationship has underscored the need for better communication.1,2 For the most part, these efforts are informed by Chafe et al.’s 6 steps that entail: (1) the identification of the error in a timely fashion; (2) determination of...
Review Article
The Impact of Clinical Guidelines and Clinical Pathways on Medical Practice: Effectiveness and Medico-legal Aspects
Guidelines for the management of specified clinical conditions are increasingly being touted as a vital component of the future delivery of health care. However, there are many guidelines that have been drawn up which have remained in the closed shelves of many clinics and hospitals.
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Others
Megatrials of Drug Treatments: Strengths and Limitations
A “megatrial” is a very large randomised controlled clinical trial (RCT) recruiting many thousands of patients from many centres in order to assess the effectiveness of treatments on clinical outcomes. Examples of megatrials which successfully recruited more than 10,000 patients include the International Studies of Infarct Survival (ISIS) series...
Original Article
End-of-life Issues—Preferences and Choices of a Group of Elderly Chinese Subjects Attending a Day Care Centre in Singapore
Doctors caring for elderly, dying and terminally ill patients are often faced with the dilemma of having to make difficult decisions especially regarding treatment where the benefit and burden is not clearly defined. Issues relating to death and dying, such as whether to disclose the diagnosis and prognosis to...
Editorial
Complementary Medicine and Evidence
While clinical medicine is increasingly governed by demands for evidence-based practice and biomedical research increasingly moves towards molecular approaches in the search for new treatments, the public is moving in a different direction—one where science is not the starting point for decision making.
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Editorial
Evidence-based Complementary Medicine—Challenges and Future Directions
There is considerable interest in complementary medicine (CM) and the usage of various alternative therapies is reportedly at an all-time high in the West. Bensoussan stated that each year, 57% of Australians were using CM with an estimated expenditure of A$621 million spent on complementary medicines (products) and A$309...
Others
The Need for Collaboration Between Clinicians and Statisticians: Some Experience and Examples
Many areas of medical research require the application of statistical techniques. Although most clinicians are taught some statistics as part of their basic medical training, the important role of statistics in medical research has led to many pharmaceutical companies, hospitals and medical research institutions employing full time statisticians to...
Review Article
End-of-life Care: Challenges and Obligations in Setting Limits to Life-sustaining Therapy
A patient with recurrent stroke disease and severe pneumonia did not respond to the previous courses of antibiotics. The medical team decided to switch to another broad-spectrum antibiotic.
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Original Article
Evidence-based Medicine (EBM) for Undergraduate Medical Students
The practice of evidence-based medicine (EBM), which integrates individual clinical expertise with the best available evidence from systematic research, demands a set of skills. These skills help clinicians retrieve, appraise and apply the current best evidence.
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Original Article
Risk Perception is Affected by Modes of Risk Presentation Among Singaporeans
The communication of risk is an important aspect of healthcare and medical research. In 2003, the British Medical Journal1 and the Journal of the Royal Statistical Society2 each published a special issue on this topic, highlighting its relevance to both clinicians and statisticians. There are various ways of presenting...
Commentary
Medication Use in the Transition from Hospital to Home
Hospital discharge can be a complex and challenging time for physicians and patients alike. Patients are being discharged sooner, often in the process of convalescence rather than at baseline health status. This requires physicians to more effectively communicate instructions for post discharge care to patients, family members, and outpatient...
Original Article
Clinical Skills in Final-year Medical Students: The Relationship between Self-reported Confidence and Direct Observation by Faculty or Residents
In clinical medical education, instructors train students in their medical knowledge and clinical skills. Medical educators also aspire to develop students’ self-confidence in medical practice.
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Original Article
Two Strategies to Intensify Evidence-based Medicine Education of Undergraduate Students: A Randomised Controlled Tria
Knowledge and skills of evidence-based medicine (EBM) can be taught by many methods, such as role modeling evidence-based care, using evidence for clinical medicine instruction, and teaching specific EBM skills. Standalone courses and workshops away from the clinical environment are usually the traditional educational designs for teachers to convey...
Commentary
Videoconsultation to overcome barriers during COVID-19
Since February 2020, Government Restructured Hospitals in Singapore began deferring non-urgent outpatient appointments. This aimed to facilitate physical distancing and reallocate healthcare resources to combat the pandemic. As the pandemic becomes increasingly prolonged, this strategy is unsustainable. There is increasing interest in using videoconsultations to ensure that patients receive...