Article type
Year
Abstract
Introduction: 75% of Australian Aborigines in the Northern Territory live in rural and remote areas. While their needs are considerable, access to even basic health care is limited. New initiatives have been introduced to encourage general practitioners to move to these areas. Developments in information technology and services like the Cochrane Collaboration have the potential to provide considerable support to isolated rural doctors.
Objective: To examine the availability of evidence relevant to the management of 5 common medical problems in a rural Aboriginal community. The information gathered from the databases available at the major referral hospital will be compared with the areas currently under study at the Cochrane Collaboration.
Methods: The 5 medical questions selected all met the following criteria: they were common rural Aboriginal health treatment strategies, they involved a considerable use of local resources, and the evidence of their effectiveness was not known to the author. Electronic searches of Medline, Australian Medical Index, the Rural Health Register and the Cochrane Database of Systematic Reviews were performed to identify relevant randomised controlled trials (RCT). Where RCT's were not available alternative evidence was considered.
Results: On the whole, relevant level 1 evidence, (RCT's), was scarce. The databases were most helpful for 2 questions also applicable to developed countries. The other 3 questions are currently research priorities in the developing world, and access to well-designed studies was limited. At present, the Cochrane Collaboration appears to be addressing 2 of the 5 questions.
Discussion: Recent developments in information technology and improved access to medical databases are changing the nature of medical practice in some fields. For general practitioners working with remote and disadvantaged groups, the relevant evidence remains difficult to access. It is likely that health divide between rich and poor extends to medical research. Overcoming this obstacle is a major challenge for the Cochrane Collaboration.
Objective: To examine the availability of evidence relevant to the management of 5 common medical problems in a rural Aboriginal community. The information gathered from the databases available at the major referral hospital will be compared with the areas currently under study at the Cochrane Collaboration.
Methods: The 5 medical questions selected all met the following criteria: they were common rural Aboriginal health treatment strategies, they involved a considerable use of local resources, and the evidence of their effectiveness was not known to the author. Electronic searches of Medline, Australian Medical Index, the Rural Health Register and the Cochrane Database of Systematic Reviews were performed to identify relevant randomised controlled trials (RCT). Where RCT's were not available alternative evidence was considered.
Results: On the whole, relevant level 1 evidence, (RCT's), was scarce. The databases were most helpful for 2 questions also applicable to developed countries. The other 3 questions are currently research priorities in the developing world, and access to well-designed studies was limited. At present, the Cochrane Collaboration appears to be addressing 2 of the 5 questions.
Discussion: Recent developments in information technology and improved access to medical databases are changing the nature of medical practice in some fields. For general practitioners working with remote and disadvantaged groups, the relevant evidence remains difficult to access. It is likely that health divide between rich and poor extends to medical research. Overcoming this obstacle is a major challenge for the Cochrane Collaboration.