Mohammad Al-Ubaydli’s blog

Annals of globalization and Google

Posted in People / organisations, Politics, Society by Dr Mohammad Al-Ubaydli on February 8, 2009

Here is the latest gem of an advert to reach me on GMail’s advertising:

rtnews

The translation is “Read now what happened in Iraq between Bush and the reporter Muntathir Al-Zaidi”. I have no idea why they advertised this to me (or this, or this), but I was so fascinated by who “they” were today: Russia Today’s Arabic edition. It seems RT has an entire web page devoted to the shoe incident, with news stories from all over the Arab world.

rtnews02

This morning I was considering paying for Relenta (started by another Russian) as a serious producitivity improvement, but honestly the thought of losing out on the entertainment of GMail adverts saddens me.

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Saudi Arabia’s free speech violations #78: you cannot even discuss football

Posted in Arabs and Arabic, People / organisations, Society by Dr Mohammad Al-Ubaydli on February 6, 2009

Here is a wonderful video featuring Prince Sultan bin Fahad, سلطان بن فهد, the first person in a long time to get me interested in football:

A little background for those who cannot understand Arabic. Saudi Arabia’s football team lost against Oman’s in the Gulf Cup. Not every team is as great as Bahrain’s.

The video shows some post-match commentary on Saudi Arabian television. Now, personally, I think that watching a football match is a waste of my time, but watching commentary about a football match is a far worse use of my time. Most commentary is low quality, and when you consider the topic of football…

Still, in a country like Saudi Arabia, football is one of the few outlets of free debate. In this case, the commentartors began critiquing the strategy, or lack thereof, of the football team. Then they opened up the phone lines for viewers. One of the viewers was Prince Sultan bin Fahad, president of the kingdom’s Youth and Sports department, i.e. the sports minister.

You do not need to understand Arabic to understand the thoughts of the commentators by watching their facial expressions or hearing the Prince’s shouting. He ended by saying: “If you’re not well-mannered enough, then let me educate you myself”.

Why patients are worried by national electronic medical records

Posted in Medicine, Technology by Dr Mohammad Al-Ubaydli on February 4, 2009

I just spent a wonderful day at Leeds University’s Masterclass in Designing Future eHealth System. There were some very impressive participants, and everyone was generous with their knowledge and expertise.

As I arrived back at Leeds train station though I saw this poster below:

systemoneI took a photo with my phone as I just found the phrasing so striking. It falls into The annals of (what) were they thinking?

The poster, about TTP‘s systemone, says:

8.5 million patient records, twenty thousand users
the future of patient care

I am sure that TTP is proud that their tools store the records of 8.5 million patients, and that 20,000 clinicians use these tools. But there seems to be no worry about the possibility of reading that poster as: there are 20,000 users, each of whom can read the records of 8.5 million patients.

This lack of worry worries many patients as they consider national medical records databases.

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Professionalism when you have no privacy: advice for medical students

Posted in Society by Dr Mohammad Al-Ubaydli on February 4, 2009

This post is the result of a conversation I had with David Doherty (3G Doctor), Dawson Costello (Medical Student Blog) and Rob Navarro (Sapior) on my birthday. I know I should have been discussing more entertaining topics but when faced by three incredibly bright and interesting people I cannot help but try and learn from them. They certainly got me thinking and any errors below are due to my thinking.

The other day I saw a Facebook status update for a medical student saying that he was “Hating patients”. When someone tried to teach the student that this was a foolish sentence to write the student said he thought no one would find his writing interesting. This is a serious error of judgement.

I am not a fan of Facebook’s founder, and one of the things that trouble me the most about the site is that it encourages a mental model of privacy but has a business model of publicity. In other words, people are comfortable sharing information because they have the impression of private conversations with friends, but fundamentally Facebook benefits from spreading your messages as far and wide as possible. This is why they ban applications that reduce the number of “friends” you have.

The comfort you should feel in Facebook is the same you should feel about picking your nose while in your car: it feels private, but everyone can see you. And with video phones, if you are famous enough, someone will record you.

In the long run, this will not be a problem for most people. First, as everyone gets caught doing something stupid in a social network website, legislation will arise to minimize the fallout, just as politicians step in when everyone makes financial mistakes by borrowing too much or saving too little. Second, and more significantly, people will be more forigiving as they see that everyone is falliable. In 2005 there was a witch hunt over a South Korean woman caught on video phone failing to clean up after her dog in a railway carriage appeared on the internet. In 2015 there will be no such recriminations, in South Korea at least, as such an incident will no longer be news.

But there will never be such clemency for doctors. For example, the public reaction to an NHS manager getting in touch with her friends on Friends Reunited has been severe:

Eastern and Coastal Kent PCT assistant director of strategic partnerships Caroline Davis wrote on Friends Reunited: “I now live in Dover, where I work for the NHS, bullshitting for a living, no change there then.”

I found out recently about discplinary action the trust was compelled to take. The reaction towards doctors will be even more severe. Partly this is because there are so few of us, but mainly because we have a duty to society. We receive heavily subsidized training, the public trust us with their lives, and accords us the respect of professionals.

My advice to medical students is simple: assume everything you write today will be read in 20 years’s time. John Steinbeck has a good line on this:

It seems to me that if you or I must choose between two courses of thought or action, we should remember our dying and try so to live that our death brings no pleasure on the world

What you write will definitely be availabe in that time because Google, and its more powerful successors, index and archive everything. And because storing old data costs less than the revenue from putting advertisments around those data, no matter how trivial the data seems to be. And people will definitely read what you wrote because in 20 years you will be a doctor with status in your community. Members of your community – including patients, journalists and lawyers – will regularly study your older writings to look for patterns of behaviour. Do not give them a reason to think badly of you.

If that means not using Facebook, then stop using Facebook. The privilege of being a doctor is far more significant than anything a free website can offer you.

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How can I change my life with no money?

Posted in Books, Entrepreneurship by Dr Mohammad Al-Ubaydli on February 2, 2009

On November 30th, 2008, someone typed “how can i change my life with no money” into Google. The third hit was to my blog post “There is no money in change management”. That person read the article and I doubt that it was useful to their predicament. Whoever that person is, I am sorry I could not help you. But you got me thinking… How could I change my life with no money?

how-can-i-change-my-life

The first thing to say is that no one has no money. At least, no one who has access to a computer with access t0 Google can make that claim. This point is particularly worth making if you are using a computer in a library. Even though you do not own the computer, you have access to someone that can spend money for your benefit, i.e. the library.

OutliersUsing other people’s money is a powerful secret. Henry Ford was a master at it, taking money from the orders of cars, building those cars from suppliers’ raw materials, and only then paying the suppliers. It is well worth reading his autobiography. There is lots of money out there with which to change your life. For example, instead of paying for an expensive course, ask your librarian to buy the books you need for the course and study by yourself. I do this all the time and the librarians are grateful because they have a budget to spend but need help with identifying which books would be the most useful to their community. Around the world, there are grants, scholarships and loans available to help people who are serious about changing their lives.

The next thing to say is that changing your life is hard. Really hard. You have to put in the hours and one book that has had me thinking about this is Outliers by Malcolm Gladwell. I usually gush about his books but a recent review by The Register has me chastened. The main point of the book is worth making though. There is no overnight success, success takes work, and the most successful worked the most.

So if you want to change careers it will take some time. That time includes working for free, or for low wages, to build skills in a new career. This is another example of using other people’s money because the alternative is for you to pay to gain those skills at an expensive course. The education from a job is much more practical and likely to increase your earning power than a university course, providing you are focused on learning from your job.

Finally, the best time to start is now. One of the most interesting things I learned in the USA is what happens when people change jobs. If I sound naive, it is because I had led a sheltered life while working as a doctor. Everyone I had previously worked with or for had a clinical career path mapped out. Job security was high and career progression mostly a matter of time.

But in the USA I saw my worst nightmare on a regular basis: parents fired from their jobs. I also saw something I had not dreamed of: people leaving their current jobs without a plan for what to do next. I do not recommend either scenario, but I will say that a few months afterwards each person was happier than they were in their old job. Often, they had higher salaries, and always they were in situations that they wanted to be in rather than ones they felt compelled to stay in.

So, to answer the question of the anyonymous searcher on my site: use the money of others to train yourself for a new life, and start doing so right now.

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DailyLit and a few words of wisdom from Henry Ford

Posted in Books, Technology by Dr Mohammad Al-Ubaydli on January 4, 2009

I am always on the look-out for technologies that let me read more during the day. At medical school, e-books from Peanut Reader on my Palm meant I could read while waiting for clinics to start. When I could walk to work in the USA, audio books from Audible (fair DRM policies) and EMusic (unlocked MP3 files) meant I could listen to books easily. And while commuting to work on the metro in DC the Kindle was a beautiful solution (one that my father loves too, even though he pines for the Arabic version).

DailyLitWith my Google Phone, it is a pleasure to have discovered DailyLit. It is a simple concept: you subscribe to a book and they send you installments by e-mail. The site lets you choose when to receive those installments so as to suit your schedule. What I love about it is that these installments are snack-sized – it takes five minutes to read each one – but the schedule keeps you going. So every day, I read parts of three books just as I wake up, a time I used to spend semi-conscious, unable to pick up my Kindle, but that is now quite comfortable to read with on my phone.

The books they have are quite good. Rather than the usual strategy of e-book vendors of having best-sellers – forgetting that people who like e-books love to read, and that those who love to read hate the trash that makes it to best-seller lists – they have put together a small, eclectic selection of intellectual books. Many are free, although I just paid for India Arriving, a book I still cannot describe but am absolutely gripped by.

My Life and WorkI want to highlight Henry Ford’s autobiography though, which is available free of charge as it is out of copyright. I knew the man was clever, building a huge company by using suppliers’ credit and customers’ cash to eliminate his finance needs, and that he did a lot of good, including paying the first high salaries for factory employees, but I did not know that he was such a deep thinker. The book is a pleasant surprise and there is much to quote but I will stick to this section because it is making me rethink the software design for my company‘s products (you will have to ignore the misogyny, he was still a product of his time):

My effort is in the direction of simplicity. People in general have so little and it costs so much to buy even the barest necessities (let alone that share of the luxuries to which I think everyone is entitled) because nearly everything that we make is much more complex than it needs to be. Our clothing, our food, our household furnishings–all could be much simpler than they now are and at the same time be better looking. Things in past ages were made in certain ways and makers since then have just followed.

I do not mean that we should adopt freak styles. There is no necessity for that Clothing need not be a bag with a hole cut in it. That might be easy to make but it would be inconvenient to wear. A blanket does not require much tailoring, but none of us could get much work done if we went around Indian-fashion in blankets. Real simplicity means that which gives the very best service and is the most convenient in use. The trouble with drastic reforms is they always insist that a man be made over in order to use certain designed articles. I think that dress reform for women–which seems to mean ugly clothes–must always originate with plain women who want to make everyone else look plain. That is not the right process. Start with an article that suits and then study to find some way of eliminating the entirely useless parts. This applies to everything–a shoe, a dress, a house, a piece of machinery, a railroad, a steamship, an airplane.

As we cut out useless parts and simplify necessary ones we also cut down the cost of making. This is simple logic, but oddly enough the ordinary process starts with a cheapening of the manufacturing instead of with a simplifying of the article. The start ought to be with the article. First we ought to find whether it is as well made as it should be–does it give the best possible service? Then–are the materials the best or merely the most expensive? Then–can its complexity and weight be cut down? And so on.

There is no more sense in having extra weight in an article than there is in the cockade on a coachman’s hat. In fact, there is not as much. For the cockade may help the coachman to identify his hat while the extra weight means only a waste of strength. I cannot imagine where the delusion that weight means strength came from. It is all well enough in a pile-driver, but why move a heavy weight if we are not going to hit anything with it? In transportation why put extra weight in a machine? Why not add it to the load that the machine is designed to carry? Fat men cannot run as fast as thin men but we build most of our vehicles as though dead-weight fat increased speed! A deal of poverty grows out of the carriage of excess weight. Some day we shall discover how further to eliminate weight. Take wood, for example. For certain purposes wood is now the best substance we know, but wood is extremely wasteful. The wood in a Ford car contains thirty pounds of water.
There must be some way of doing better than that. There must be some method by which we can gain the same strength and elasticity without having to lug useless weight. And so through a thousand processes.

Bahrain Medical Bulletin is Bahrain’s first open access journal

Posted in Arabs and Arabic, Medicine, Society by Dr Mohammad Al-Ubaydli on December 23, 2008

Here is a press release we sent out recently to journalists in Bahrain. I hope to announce more good news soon.

PRESS RELEASE
Issued: 23 December 2008

For Immediate Release
With support from Ministry of Health and Kuwait Finance House.

TITLE Bahrain Medical Bulletin is Bahrain’s first open access journal

Today, the Bahrain Medical Bulletin (BMB www.bahrainmedicalbulletin.com) became an open access journal. What this means is that the journal is now free to read online, and is published under a progressive copyright that allows readers to reuse the articles provided they cite them correctly.

Dr. Jaffar Al-Bareeq, Chief Editor of the BMB, said “This change is part of BMB‘s belief that medical research is an international public resource and should be provided with a copyright license that supports sharing of scientific knowledge.” Dr. Al-Bareeq founded the journal in 1979 to provide a forum for medical research in the region.

Starting with the December 2008 issue, all BMB articles are freely available online and deposited in a public archive immediately upon publication. Anyone is free to copy, distribute, and reuse BMB content as long as he or she credits the original author and source.

Dr. Mohammad Al-Ubaydli, a Senior Editor at the BMB, said “Open access publishing brings the same revolution to the publishing of scientific information that open source software brought to the creation of software”. Dr. Al-Ubaydli led the conversion of BMB to an open access journal. He is author of the book Free Software for Busy People (www.freedomsoftware.info) which discusses the use of open source software in health care.

This conversion is funded by grants from the Kuwait Finance House and the Ministry of Health. H.E. Dr. Faisal Al Hamar, Minister of Health, said “We supported this work because of its importance to medical research in the region”. Mr A. Al Khayat, from Kuwait Finance House, said “As an Islamic Bank we are delighted to provide funding for work that will ultimately improve patient care”.

Although some journals in the region already allow readers free access to their journal website, BMB is the first to allow readers to reuse the content in other ways through the open access license.

Such reuse has many powerful applications.  For example, anyone will be free to distribute any article in BMB, make translations, put the articles into course packs in universities, and make derivative educational works.  If a minister of health reads an important study in BMB, they are now free to send a copy to every health professional in the country.

This commitment to access to knowledge by a Bahraini journal complements Bahrain’s existing medical infrastructure. For example, the only Cochrane Center in the Middle East is in Bahrain. Cochrane is the international collaboration between medical scientists around the world to evaluate and identify clinical treatments for patient care.

بيان إخباري، 23 ديسمبر 2008

[بدعم وزارة الصحة والتمويل الكويتي]

مجلة البحرين الطبية: أول مجلة علمية مفتوحة في البحرين
أصبحت مجلة البحرين الطبية ومنذ اليوم (Bahrain Medical Bulletin (BMB), www.bahrainmedicalbulletin.com) أول دورية علمية مفتوحة، وبهذا باتت متاحة للقراءة على الإنترنت بلا كلفة، وتنشر حسب شروط حقوق نشر متقدمة بحيث أصبح ممكنا للقراء إعادة استعمال المقالات بشرط الإشارة الصحيحة للمصدر والكاتب.

ويقول الدكتور جعفر الإبريق رئيس تحرير المجلة: “ينطلق هذا التغيير من الاقتناع بأن البحث الطبي هو مصدر عالمي عام ويجب أن تترافق طبيعته مع الترخيص باستخدام حقوق النشر الداعمة للتشارك في المعرفة العلمية.” وكان الدكتور الإبريق قد أسس المجلة عام 1979 لإيجاد ملتقى للبحث العلمي بالمنطقة.

وبدءاً من عدد ديسمبر 2008، فإن كل مقالات مجلة البحرين الطبية ستكون منشورة للاستخدام المجاني عبر الإنترنت وستُخزّن فوراً في أرشيف عام وقت النشر. وسيحق لأي مستخدم أن ينقل أو يوزع أو يعيد استخدام محتويات المجلة طالما قام الشخص بالتوثيق للمؤلف الأساس وللمصدر.

وقال الدكتور محمد العبيدلي أحد كبار المحررين بمجلة البحرين الطبية إن “النشر المفتوح يحقق بعالم نشر المعلومات العلمية نفس الثورة التي أدخلها برامج المصدر المفتوح لعالم إبداع برامج الحاسوب.” وكان الدكتور العبيدلي قد قاد عملية تحويل المجلة إلى نشرة مفتوحة. وهو مؤلف لكتاب “البرامج المجانية للأناس المشغولين” (www.freedomsoftware.info) والذي يناقش استخدام برامج المصدر المفتوح في العناية الطبية.

ولقد موّلت عملية التحويل بمنح قدمها بيت التمويل الكويتي ووزارة الصحة. وقال الدكتور فيصل الحمر، وزير الصحة: “موّلنا هذا البحث لأهميته للبحث الطبي في المنطقة.” وقال السيد عبدالحكيم الخياط من بنك التمويل الكويتي بأنه وبالنظر: “لكون البنك مصرفاً إسلامياً فإننا سعداء لتوفير تمويل لعمل سيحسن بالنهاية العناية بالمريض.”

وعلى رغم من أن بعض المجلات الطبية بالمنطقة قد بدأت بالسماح للقراء بالاطلاع الحر على مواقعها، فإن مجلة البحرين الطبية هي الأولى في منح حق استخدام المحتويات وبأية طرائق أخرى عبر منح ترخيص الاستخدام المفتوح.

ويمكن لهذا الحق أن يمكّن من تطبيقات قوية متعددة. مثلاً، يمكن لأي شخص أن يوزع  أي مقال بالدورية أو يقوم بترجمته، أو يضمن مقالة ما بأي مقررات للتدريس بالجامعات، وأن يحقق أية أعمال مشتقة من تلك المقالات. ويحق بذلك لأي وزير صحة اليوم وحينما يقرأ دراسة مهمة بالمجلة أن يرسل نسخة منها لأي محترف للعناية الصحية بالبلد.

ويكمل الالتزام بحق استخدام المعرفة الذي تمنحه مجلة بحرينية، البنية التحتية الطبية البحرينية القائمة. وعلى سبيل المثال فإن فالبحرين تضم مركز كوكرين الوحيد بالشرق الأوسط. وكوكرين هو تعاون دولي بين العلماء الطبيين حول العالم لتقييم وتحديد العلاجات السريرية للعناية بالمريض.

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Bahrain should Adopt Open Source Electronic Medical Records

Posted in Medicine, My publications, Peer-reviewed papers, Technology by Dr Mohammad Al-Ubaydli on December 1, 2008

This paper was published as an editorial in the December 2008 issue of Bahrain Medical Bulletin.

Mohammad Al-Ubaydli, MB, BChir, MA, Cantab. Honorary Senior Research Associate, University College London, UK. E-mail me@mo.md.

Bahrain should Adopt Open Source Electronic Medical Records

As Bahrain begins the switch to electronic medical records the use of open source software becomes increasingly important. Without it, the country’s public health data is at the mercy of private companies, local young innovators are unable to contribute solutions, and the citizens’ fears about how data is used will lead to patients withholding information from their doctors.

However, with open source software, the country gains the accountability from its vendors, locally-led solutions to our health problems can emerge, and all of us as patients can trust the health care system with the safety of our records.

Open source software is software for which the source code is openly available for inspection and reuse. Inspection of the source code in software development is equivalent to peer review in medicine and science. It is the best way to critique software, ensure honesty and improve quality.

The reusability of the software also decreases costs. This is not just because the software is available free of charge but rather because the creators of closed source software keep on reinventing the wheel. They keep on spending money to write parts of their new software that have already been written by other programmers around the world. In addition, they pass on those costs to the end customer.

Perhaps the best illustration for why Bahrain should adopt open source software is Britain’s experience with closed source software in the National Health Service. The government’s aim was to bring the benefits of electronic medical records to all UK citizens.

Starting in 2002 the UK government began what was arguably the most complex and best-funded IT project in the world. Companies from all over the world were keen on winning the contracts because of their size and prestige. Richard Granger was recruited and became the most highly paid civil servant, earning £100,000 more than Prime Minister Tony Blair does. The government did this because it wanted the best possible controls over the delivery of the software by the private contractors.

Moreover, the government remains at the mercy of the contractors. Initially only iSoft won three of the five regions in England, and General Electric (GE) won two. Soon, problems with GE’s deployment meant that it had to give up one of its regions and Cerner took over that contract. Of course each company brings its own proprietary closed source software and reusing existing software is not possible. Meanwhile problems and delays continue. The government is unlikely to get other companies to fix future problems because the pool of companies is so small and the problems have been so large. How would the Bahraini government be able to avoid these problems?

It is noteworthy that most of the contracts have been won by American companies. Microsoft, Cerner, Accenture, GE, CSC are but few, and British companies like BT and iSoft are in the minority, until iSoft itself was bought by an Australian company. It is right for the government to demand the best software from the best companies around the world but the insistence on large contracts of closed source software has locked out much of Britain’s previously vibrant health care IT industry. Companies like EMIS publicly expressed their frustration at their inability to participate even though they had the largest market share of software for General Practitioners.

Meanwhile many start-ups in the UK had to refocus their efforts on selling outside the UK as they are barred from integrating their software to the closed source of the winners of the large contracts. How would the Bahraini government be able to support local innovators?

Finally, the transparency in the governance of medical records is crucial. In the UK original plans were to allow medical records to travel from any doctor’s medical record’s system to the central database, and then to any NHS doctor. Patients felt that they had lost control over the data, and letters to newspapers expressed citizens’ distrust of the security controls. After all there was no way of inspecting the source code of the software that transferred the data to ensure that it does so securely, much less give the patient control over the transfer of the data. Some patients began refusing to tell their doctors about some of their illnesses because they feared the loss of control. A key part of patient-doctor confidentiality had been broken. How would the Bahraini government reassure its citizens?

Open source software offers a simple and cost-effective solution. Open source electronic medical records software tools are available free of charge. For example, VistA (the Veterans Health Information Systems and Technology Architecture) was created by the U.S. Department of Veterans Affairs (VA) as far back as 1982 to support the care of U.S. veterans and is the world’s most widely deployed and carefully tested Electronic Health Record systems (EHR)1. Versions of this system are in active use in the U.S. Department of Defense Military Health System, the U.S.

Department of Health and Human Services Indian Health Service, and internationally as well, e.g., Mexico – Instituto Mexicano del Seguro Social, Berlin Heart Institute of Germany, and National Cancer Institute of Cairo University in Egypt.

Using the software would transform Bahrain’s efforts. Contractors could bid for how well they deploy and support the software. If there are problems, as there were with closed source software contractors in the UK, it would be easy to replace them by others who would provide better services. Local innovators would also be encouraged. First, Bahraini programmers could learn from the best in the world because they could study the source code free of charge. Second, they would be able to build solutions on top of VistA without needing the permission of contractors. A suite of localized solutions could emerge, and Islamic-friendly software could be exported to other Muslim countries that have the same aspects to the delivery of medical care. Finally, the problem of transparency would be solved. When a government minister in the UK says that NHS software is safe, there is no way to confirm the accuracy of his or her statements. Nevertheless, open source software could be inspected and tested for these claims. Not every citizen has to be a programmer for this to be the case, but the programmers in our midst could carry out the tests for their fellow citizens.

Surely we all deserve these benefits as we embrace the future with open source arms.

Note

1. VistA (http://worldvista.org/AboutVistA) is open source medical software made by the U.S. Department of Veterans Affairs (VA), as opposed to Windows Vista the closed source operating system software made by Microsoft.

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I am one of Courvoisier’s Future 500

Posted in Awards, People / organisations by Dr Mohammad Al-Ubaydli on November 30, 2008

I have been accepted as one of “The Future 500” for Courvoisier’s competition because of the work I am doing at UCL medical school and Patients Know Best. The full list of 500 is published in Today’s Observer newspaper and on Thursday I get to meet them in London.

Launched in 2007, Courvoisier The Future 500 is an exclusive private members network for rising stars across the UK. It is your own private rolodex linking you with talent that ranges from the arts to business.

Selected by a panel of inspirational judges, all members have achieved significant success in their field – be it as an artist, businessman, entrepreneur or activist.

Courvoisier has created a platform for Britain’s brightest talents to connect, share their vision, inspire one another and ultimately collaborate to achieve even greater success…

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Bahrain tops Cochrane league table in the middle east

Posted in Arabs and Arabic, Medicine, People / organisations by Dr Mohammad Al-Ubaydli on November 29, 2008

By October 2008 Bahrain’s Cochrane center had published 10 evidence-based medicine reviews, topping the output of Egypt (8), Pakistan (8), Iran (6) and Saudi Arabia (4). In fact, in the Middle East, only Israel has produced more reviews, with 24 published to date. But Cochrane Bahrain only started publishing in 2004 and with 4 reviews published this year to Israel’s 2 I have high hopes for the future.

Why is this important? Cochrane reviews themselves are important because they represent the medical profession’s consensus evaluation of what treatments work and what other treatments to avoid. Its authors look at all existing research for each disease and treatment. The output of this international body of clinical scientists improves patient care every day.

Bahrain’s performance is important because of what it says about the country’s integration with rigorous international scientific work. But its relative performance to that of its wealthier and larger neighbours is what impresses me the most. If you take reviews per capita, Bahrain manages to top even the output of Israel.

I hope that the Bahraini government increases its funding of Cochrane Bahrain, the only such center in the Arab world and one which is becoming a model for other centers around the world.

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