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Levels of Evidence within Cardiovascular Medicine Research in Saudi Arabia: A Systematic Review.

ABSTRACT: International commitments to reduce the prevalence of non-communicable disease have led the Government of Saudi Arabia to invest more in research related to cardiovascular disease. However, the strength of evidence derived from these research activities remains unclear. The aim of our study was to examine the level of evidence within clinical Cardiovascular Medicine research in Saudi Arabia. We conducted a systematic review of published articles that included a population from Saudi Arabia. Electronic databases EMBASE and MEDLINE (Ovid) were searched up to 25^th of April 2021, supplemented by a second search in CENTRAL (Cochrane Central Register of Controlled Trials) and www.clinicaltrials.gov. In addition, the Snowball- and Pearl-growing methods of search were conducted for finding additional eligible articles. Finally, a search was conducted in PubMed database for all eligible articles published by Journal of the Saudi Heart Association from the first indexed issue up to April 2021. Level of evidence of reviewed articles was determined using the Oxford Level of Evidence 2 scale. We calculated the mean level of evidence over 5-year periods, and explored evidence for a time trend for number of published articles and LOE using linear regression. Of the 1113 records identified, 418 met the inclusion criteria for analysis. The articles were published between September 1986 and March 2021. More than half of the included articles were level IV studies (n = 242, 57.8%). Furthermore, we observed no trend over the years for increased mean of level of evidence (β = -0.07, 95% CI [-0.20, -0.06], p = 0.236). Overall, the level of evidence produced by the articles in clinical Cardiovascular Medicine in Saudi Arabia is very low. Prioritizing higher-quality research is critical to produce the clinical practices and policies necessary to reduce the burden of cardiovascular diseases in Saudi Arabia.

SUBMITTER: Alotaibi S

PROVIDER: S-EPMC8425340 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundPatient safety, concerned with the prevention of harm to patients, has become a fundamental component of the global healthcare system. The evidence regarding the status of the patient safety culture in Arab countries in general shows that it is at a suboptimal level due to a punitive approach to errors and deficits in the openness of communications.ObjectivesTo identify factors contributing to the patient safety culture in Saudi Arabia.DesignSystematic review.MethodsA systematic search was carried out in May 2018 in five electronic databases and updated in July 2020-MEDLINE, CINAHL, Embase, PsycINFO and the Cochrane Database of Systematic Reviews. Relevant journals and reference lists of included studies were also hand-searched. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of studies and extracted their relevant characteristics. The Yorkshire Contributory Factors Framework (YCFF) was used to categorise factors affecting safety culture in the included papers.Results14 papers were included and the majority of studies were appraised as being of good quality. Strength and weakness factors that contribute to patient safety culture were identified. Ineffective leadership, a blame culture, workload/inadequate staffing and poor communication are reported as the main factors hindering a positive patient safety culture in Saudi Arabia. Conversely, 'strength' factors contributing to a positive patient safety culture included supportive organisational attitudes to learning/continuous improvement, good teamwork within units and support from hospital management for patient safety. There is an absence of patient perspectives regarding patient safety culture in Saudi Arabia.ConclusionPolicymakers in the Saudi healthcare system should pay attention to the factors that may contribute to a positive patient safety culture, especially establishing a blame-free culture, improving communications and leadership capacity, learning from errors and involving patient perspectives in safety initiatives. Further research is required to understand in depth the barriers and facilitators to the implementation of a positive patient safety culture in Saudi Arabia.

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Levels of Evidence within Cardiovascular Medicine Research in Saudi Arabia: A Systematic Review.

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