A Systematic Review of Medical and Clinical Research Landscapes in Primary Medical Care in Malaysia
Boon-How Chew,1 Shaun Wen Huey Lee,2 Lim Poh Ying,3 Soo Huat Teoh,4 Aneesa Abdul Rashid,1 Navin Kumar Devaraj,1 Adibah Hanim Ismail Daud,1 Abdul Hadi Abdul Manap,1 Fadzilah Mohamad,1 Aaron Fernandez,5 Hanifatiyah Aliy,1 Puteri Shanaz Jahn Kassim,1 Nurainul Hana Shamsuddin,1 Noraina Muhamad Zakuan,6 Akiza Roswati Abdullah,7 Indah S. Widyahening8
This systematic review aimed to describe the characteristics of clinical and biomedical research in Malaysia.
A search was conducted on PubMed, Embase, CINAHL, PsycINFO, and MyMedR (http://mymedr.afpm.org.my/) for published clinical and biomedical research in primary care settings from 1962 to 2017 by Malaysian authors in a Malaysian institution. Studies found were independently screened by a team of reviewers and information was extracted.1,2 In phase 1, the characteristics of the research and profiles of the researchers and journals in which they were published were reported descriptively. In phase 2, the quality of studies included in phase 1 will be assessed using a newly developed tool to ascertain risk of bias. Longitudinal trends of the research characteristics, health conditions studied (International Classification of Primary Care), and settings, among other characteristics, were explored. No synthesis of results was conducted as no effect estimates were available to be pooled.
Of 4513 articles, 1078 were included in this qualitative synthesis and 790 with complete data were analyzed. Clinical studies (81.9%), primary research (81.1%), and quantitative studies (74.2%), consisting mostly of prevalence studies (67.7%) by cross-sectional sampling (70.4%), were predominant. The number of studies increased (Figure 30) and the number of characteristics also increased after year 2000. Researchers from family medicine (39.3%) and public health (15.2%) specialties were the main contributors to the articles (Figure 30, A). Most of the corresponding authors had a master of medicine degree (46.5%) compared with a doctor of philosophy (PhD) (24.4%) or doctor of medicine (MD) (5.2%) degree. Researchers with PhD and MD degrees were more likely to conduct interventional studies compared with those with master’s degrees (8.0% vs 6.4% of studies; χ² = 54.26; P = .03). Publications were mainly original research (82.8%) in international (48.6%) or local (35.0%) journals and were evenly distributed between multidisciplinary (51.6%) and discipline-specific (46.6%) journals. The number of authors per article was most often fewer than 5 (73.6%), and the number of collaborating institutions was predominantly fewer than 3 (82.5%). Incidences of coauthorship and collaboration with overseas researchers were few but showed a significant increasing trend in the last decade (Figure 30, B). The top 5 conditions studied were general and unspecified (37.9%); endocrine, metabolic, and nutritional (15.2%); circulatory (7.8%); psychological (5.9%); and respiratory (4.9%).
The longitudinal and prospective trends of the research characteristics assessed in this analysis provided suggestions of improvement initiatives needed for primary care research enterprise in Malaysia. This includes training on the proper use of different study designs, on developing a better supportive ecosystem for interventional clinical trials, on skills for international research collaboration, and for strategizing research topics that meet the issues of primary medical care. Similar works in other disciplines could be initiated and better conducted after this first experience. The aim of phase 2 will be to validate a research-quality screening tool based on domains of relevance, credibility of the methods, and usefulness of the results.
1. Chew BH, Lim PY, Lee SWH, et al. A systematic review of medical and clinical research landscapes and quality in Malaysia and Indonesia [REALQUAMI]: the review protocol. PROSPERO identifier: CRD42020152907. Updated April 28, 2020. Accessed July 14, 2022. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=152907
2. Chew BH, Lim PY, Lee SWH, et al. A systematic review of medical and clinical research landscapes and quality in Malaysia and Indonesia [REALQUAMI]. OSF Registry for Research on the Responsible Conduct of Research. May 1, 2019. Accessed July 14, 2022. https://osf.io/w85ce
1Department of Family Medicine, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Selangor, Malaysia, firstname.lastname@example.org; 2School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Selangor, Malaysia; 3Department of Community Health, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Selangor, Malaysia; 4Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia, Penang, Malaysia; 5Department of Psychiatry, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Selangor, Malaysia; 6Department of Biomedical Sciences, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Selangor, Malaysia; 7Medical and Health Sciences Library, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Selangor, Malaysia; 8Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Conflict of Interest Disclosures