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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,...

Nanospheres of Biodegradable Polymers: A System for Clinical Administration of an Anticancer Drug Paclitaxel (Taxol®)

Paclitaxel (Taxol®) is a diterpenoid extracted from the bark of a rare, slow growing Pacific yew or Western yew tree (Taxus brevifolia). Its antitumour...

Pharmacogenetics: Role in Modifying Drug Dosage Regimens

Synder in 1932 wrote the first report on the Mendelian inheritance of the inability to taste phenylthiourea. Twenty-five years later, Arno Motulsky suggested hereditary...

Post-Release Drug Treatment Risks: Strategies to Minimise Harm to Patients

Physicians have long accepted unreliable evaluations of the risks attached to pharmacotherapy, i.e. treating our patients with drugs. The reasons for the uncritical attitude...

Clinical Drug Evaluation: The Regulatory Perspectives

Evaluating new drugs for marketing approval is a highly specialised and knowledge-intensive activity. This is especially so if the intention is to conduct quality,...

Meta-analyses of Clinical Drug Trials—Gold Standard Reviews or Statistical Alchemy?

Informal review and synthesis of scientific evidence has been practised for as long as experiments have been replicated. The idea of quantitatively combining the...

Clinical Drug Trials: Practical Problems of Phase III

There has been a rapid increase in clinical trial activity in Singapore and other parts of Asia. Randomised clinical trials are the “gold standard”...

Design of Phase I and II Clinical Trials in Oncology and Ethical Issues Involved

Drug development is costly and time-consuming in terms of economic, patient and research resources. An integrated effort involving academia, industry, and regulatory authorities is...

Clinical Drug Development—Practical Issues in Clinical Pharmacology Studies

Clinical pharmacology (CP) as a discipline comes in many guises. The perception for a medical student, and for many doctors, may be that of...

A Review of Software for Data Management, Design and Analysis of Clinical Trials

In clinical trials, subjects are usually entered one at a time, and their responses to treatment monitored sequentially. Regular monitoring of trial progress during...

Assessment of Patient Sociodemographic Variables in Clinical Trials—Can Patient Characteristics Make a Difference?

The pathway by which patients enter clinical trials can be a selective, non-random process. In order for patients to enter clinical trials, a set...

Estimation of Number of Subjects Required for Comparison of Drug versus Control in Adaptive Designs

Traditional designs for clinical trials make balanced (or 50-50) allocation of patients to treatments. This is done in the past to minimise the variance...

Randomisation: Magical Cure for Bias?

There is general consensus that randomised clinical trial (RCT) can provide the most valid conclusions about effects of different treatment as eligible patients are...

The Ethics of Placebo-Controlled Trials in Developing Countries to Prevent Mother-to-Child Transmission of HIV

Placebo-trials on HIV-infected pregnant women in developing countries like Thailand and Uganda have provoked recent controversy. Such experiments aim to find a treatment that...

Evaluating Drugs from Cradle to Grave—Evolving Systems for a Complex Activity

Are medicines dangerous chemicals or life enhancing agents? The answer is ‘Both of those things, often at the same time, and worse in the...

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...

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....

Methodologies for Interventional Myopia Studies

Past studies on intervention in myopia progression have given conflicting results. For example, in the past, studies on (PMMA) hard contact lenses took researchers...

Teaching Community, Occupational and Family Medicine at the National University of Singapore: Past, Present and Future

The Department of Community, Occupational and Family Medicine (COFM), previously the Department of Social Medicine and Public Health (SMPH), was inaugurated in 1948 as...

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....

Prospective Randomised Study of Intra-Articular Fractures of the Distal Radius: Comparison Between External Fixation and Plate Fixation

Intra-articular fractures of the distal radius represent high energy, complex, unstable injuries and the optimal treatment remains controversial. Kreder et al1 showed that external...

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...