Evidence Based Medicine - Advocating the Practise of and Educating the Public How to Choose Wisely

Today I was privileged to meet two powerful and influential ladies, Prof Dr Jacqueline Ho, a paediatrician who is the Deputy Dean of Penang Medical College (the best private medical school in Malaysia by ranking I was told) and the Director of the Malaysian Cochrane under Australasia Network, with her good friend Dr Sharifah Halimah Jaafar, Consultant Obstetrician and Gynaecologist at KPJ Hospital, Ipoh. The meeting took place at Prof Jackie's beautiful Ipoh residence.

The circumstances could have been better, I was on the way from Perak to PJ with kids (and their dad) waiting in the car, Prof Jackie had just returned from Vietnam the day before and Dr Sharifah had to rush to finish her ward rounds in order for the meeting to materialise.

The reason for meeting was to discuss the idea of starting a healthcare consumer or advocacy group, an NGO (it was decided this morning), which is common in developed nations, that educates consumers to make informed decisions with regards to the various healthcare products and services available in the market. The NGO will also advocate the practise of evidence based medicine amongst healthcare worker especially the doctors in Malaysia.

The findings could potentially be presented at the Cochrane Colloquium in Hyderabad, on the Malaysian experience educating the public on evidence based medicine and how it may change the practice of medicine in Malaysia.

Anyone interested to help/contribute/be one of the seven committee members/know anyone who would possibly be interested to participate, please be in contact. We welcome consumer representatives, in addition to persons with relevant medical/pharmaceutical/healthcare background. Passion for advocacy of evidence based medicine would be preferable.

• Dr: Great! Looks like we have a good number to form a strong team to spearhead the movement! Healthcare advocacy group is about educating the public on what scientific evidence is about, how reliable is it and how they can find a reliable medical evidence to answer their question whether or not the intervention (treatment/test/procedure) they interested in has any effect or not (positively or negatively). That would help them in making a wise medical decision and go for best option. 

  
  
• For TCT: Public need to know when someone said the treatment works for them it doesnt mean it works for everybody. That is only a claim or we call it a testimony evidence (very convincing because it always report good effect but conceal the bad effect..best marketing strategy for alternative medicne). The treatment has to be put to a fair test/trial first to see whether it has an effect beyond the placebo effect before we can declare it has any effect, good or bad. Another example is mammography: It has been promoted for best screening for breast cancer and public are encouraged overwhelmingly to do it regularly. however according to the best available medical evidence which was published in July 2013, the number of healthy women being converted to become a ''breast cancer' patient is far far higher than the actual number of real case. In this case there is higher negative effect (harm) than benefit. You may rightly argue that that evidence may not accurate, thus you may want to examine the reliability of the evidence by looking at it methodology. After knowing the information, it is not that we want to discourage the public or go against it BUT we may include this information when we counsel our patient about this test so that they will make an informed choice whether or not to go for a mammogram. So the decision is no longer rely on what we believe or whats popular but it on reliable good medical evidence at current time. That is what we called today as ..BEST MEDICAL PRACTISE ..wallahualam
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• TCT: Dr. S, my intention is to alert the main stream medical communities to look into this alternative therapy. I was sceptical initially but I was convinced after I experienced it first hand myself.
• The first person who benefited from my OPT is a Malay gentleman who works in police force as technician. He came to me to purchase Lintzhi (Ganoderma Lucidum) capsules. I asked him what is the purpose of buying the capsules, he told me he was suffering from breathing difficulty and chest pain for more than 6 months. He went to GH and consulted two specialists (CT Scan) but couldn't find the reason of his sickness. Then I remember OPT which I learned from watching the Youtube videos. I asked him to bend down on the table and I massaged his upper "Origin Point" for about 3 minutes. He felt relief immediately and he told me almost 80% of his pain gone. He came back to me about 2 weeks later for another round of massaging and I taught him the method so that he could do it himself (with help of family members). That was the last time I saw him. The last words he told me was, I should open a clinic to provide OPT service. Hahaha......
  
  P/S: BTW, I am in IT business.

• Dr S: Tan CT: precisely! As I have said..when someone said the treatment works for them, it doesn't mean it works for everybody. Any intervention be it a main stream medicine or alternative..it has to surpass placebo effect before we can declare it effective scientifically. Only then we can say with certain level of confidence that the intervetion has an effect., looks like we have begun advocating and educating best practice here...in your FB!!

  
  
• Dear all, Volunteers please email me, include your full name, vocation, organisation, location and contact number. Message from PJ and DrS: Next step is to decide on the meeting (First AGM) somewhere early next month depending on everybody's availability, to establish the framework and draw a constitution. Please suggest some dates. (16th November/Saturday is good for me). Thanks everyone.
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• Dr S:16th November is good for me too but I will accomodate any dates that suit everybody..The next thing is to decide where to meet? Since everybody is in KL I will ask PJ whether her dirver can take both of us down on the decided date.. J comes back to Ipoh every weekend, so I guess the meeting best to be on saturday after work or sunday
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  We also need to get some reporter to bring message of best practice and evidence based medicine to the public..and to annouce to the public that we are the advocacy group who help the public understand what best practice is all about and how they can participate in their health decision making..
• I will have to make a facebook group for this NGO temporarily, to facilitate info-sharing

  
  
• Dr S: yes, it a good idea, we must also have a few non doctor in our group in order to look at the consumer prespective..The doctors will look at improving best practise among doctors population