Annals of the Academy of Medicine, Singapore最新文献

{"title":"Illicit drug consumption in Singapore: Where are we in the fight against drugs?","authors":"David Choon Liang Teo, Sanjiv Nair Sasidharan, Rasaiah Munidasa Winslow","doi":"10.47102/annals-acadmedsg.2024134","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2024134","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting evidence-based care for children and adolescents on the autism spectrum.","authors":"Shang Chee Chong, Fams Lai Yun Ho","doi":"10.47102/annals-acadmedsg.2024132","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2024132","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare burden of cognitive impairment: Evidence from a Singapore Chinese health study.","authors":"Junxing Chay, Woon-Puay Koh, Kelvin Bryan Tan, Eric A Finkelstein","doi":"10.47102/annals-acadmedsg.2023253","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2023253","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment (CI) raises risks for unplanned healthcare utilisation and expenditures and for premature mortality. It may also reduce risks for planned expenditures. Therefore, the net cost implications for those with CI remain unknown.</p><p><strong>Method: </strong>We examined differences in healthcare utilisation and cost between those with and without CI. Using administrative healthcare utilisation and cost data linked to the Singapore Chinese Health Study cohort, we estimated regression-adjusted differences in annual healthcare utilisation and costs by CI status determined by modified Mini-Mental State Exam. Estimates were stratified by ex ante mortality risk constructed from out-of-sample Cox model predictions applied to the full sample, with a separate analysis restricted to decedents. These estimates were used to project differential healthcare costs by CI status over 5 years.</p><p><strong>Results: </strong>Patients with CI had 17% higher annual cost compared to those without CI (SGD4870 versus SGD4177, P<0.01). Accounting for the greater mortality risk, individuals with CI cost 9% to 17% more over 5 years, or SGD2500 (95% confidence interval 1000-4200) to SGD3600 (95% confidence interval 1300-6000) more, depending on their age. Higher cost was mainly due to more emergency department visits and subsequent admissions (i.e. unplanned). Differences attenuated in the last year of life when costs increased dramatically for both groups.</p><p><strong>Conclusion: </strong>Ageing populations and higher rates of CI will further strain healthcare resources primarily through greater use of emergency department visits and unplanned admissions. Efforts should be made to identify at risk patients with CI and take appropriate remediation strategies.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2023 clinical practice guidelines on autism spectrum disorder in children and adolescents in Singapore.","authors":"Chui Mae Wong, Mariam Aljunied, Daisy Kwai Lin Chan, Janice Mun Yi Cheong, Bernard Chew, Chee Hon Chin, Sylvia Henn Tean Choo, Angelia Hwee Ling Chua, Magdalene Tze Suang Foo, Tze Jui Goh, Majeed Khader, Stephenie Koon Miang Khoo, Hwan Cui Koh, Wee Bin Lian, Hong Huay Lim, Kenneth Kin-Loong Poon, Zi Lin Sim, Min Sung, Peng Chian Tan, Sarah Yong, Guiyue Zhang, Ramkumar Aishworiya","doi":"10.47102/annals-acadmedsg.2023307","DOIUrl":"10.47102/annals-acadmedsg.2023307","url":null,"abstract":"<p><strong>Introduction: </strong>Autism is a neurodevelopmental condition that is increasing in prevalence worldwide. There has been an exponential increase in autism-related research since 2010, when the first Singapore Clinical Practice Guidelines (CPG) on autism was published. Understanding of autism has since evolved to adopt a lifespan approach beyond that of a childhood condition. The aim of this CPG was to provide an updated set of recommendations for children and adolescents to aid clinical practice for professionals.</p><p><strong>Method: </strong>A multidisciplinary workgroup that comprised representatives from various sectors worked on this CPG. Clinical questions were organised into 10 different sections, each with its own subgroup of members. Seventeen existing international guidelines were evaluated using the Appraisal of Guidelines for REsearch & Evaluation II (AGREE-II) framework, of which 4 met criteria to act as references. Literature review across multiple databases was conducted between January 2011 to 2023; Grading of Recommendations, Assessment, Development and Evaluation (GRADE-like) methodology was used to synthesise evidence. Recommendation statements were derived, following Delphi-style consensus surveys among the workgroup. The draft guidelines underwent external review and public consultation before being formalised.</p><p><strong>Results: </strong>Recommendation and good practice statements pertaining to care of children and adolescents on the autism spectrum across 10 different sections were developed. Evidence matrices complement these recommendations and detail relevant evidence behind each recommendation statement.</p><p><strong>Conclusion: </strong>It is intended for these guidelines to promote effective management and healthcare services for children and adolescents on the autism spectrum, by reinforcing good and evidence-based clinical practice within our national context.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VOWELS: A communication framework for disclosing medical errors in medical oncology and palliative care.","authors":"Jamie Xuelian Zhou, Crystal Lim, Lalit Kumar Radha Krishna","doi":"10.47102/annals-acadmedsg.2023380","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2023380","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health District at Queenstown: Catalyst for translational research.","authors":"David Michael Allen, Emi Kiyota, John Eu Li Wong","doi":"10.47102/annals-acadmedsg.2023369","DOIUrl":"10.47102/annals-acadmedsg.2023369","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening of nasopharyngeal cancer in high-risk familial cohort: A practical approach using a screening algorithm.","authors":"Jia Jia Wee, Isabelle Jia Hui Jang, Neville Wei Yang Teo, Ian Chi Yuan Loh, Tze Choong Charn, Donovan Kum Chuen Eu, Raymond King Yin Tsang, Ming Yann Lim, Lilleen Minyi Huang, Paul Kan Hwei Mok, Song Tar Toh, Chwee Ming Lim","doi":"10.47102/annals-acadmedsg.2023273","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2023273","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in genetic screening for inherited endocrinopathy affecting the thyroid, parathyroid and adrenal glands in Singapore.","authors":"Diluka Pinto, Mechteld C de Jong, Rajeev Parameswaran","doi":"10.47102/annals-acadmedsg.202368","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.202368","url":null,"abstract":"<p><p>Significant progress has been made in the understand-ing of many human diseases, especially cancers, which has contributed to improved and increased survival. The Human Genome Project and The Cancer Genome Atlas project brought about a new era, with an understanding of inherited diseases at a molecular level, which subsequently facilitated the option of precision medicine. Precision medicine has helped tailor treatment decisions at an individual level, for instance in terms of surgical treatments or targeted therapies in advanced diseases. Despite the increasing advances in genetic-lead precision medicine, this has not translated into increasing uptake among patients. Reasons for this may be potential knowledge gaps among clinicians; on reasons for poor uptake of genetic testing such as for cultural, religious or personal beliefs; and on financial implications such as lack of support from insurance companies. In this review, we look at the current scenario of genetic screening for common inherited endocrine conditions affecting the thyroid, parathyroid and adrenal glands in Singapore, and the implications associated with it.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of consumption of illicit drugs and associated factors from a nationwide epidemiological survey: The Singapore Health and Lifestyle Survey.","authors":"Mythily Subramaniam, Yen Sin Koh, Rajeswari Sambasivam, Edimansyah Abdin, P V Asharani, Janhavi Ajit Vaingankar, Boon Yiang Chua, Hong Choon Chua, Cheng Lee, Wai Leng Chow, Stefan Ma, Siow Ann Chong","doi":"10.47102/annals-acadmedsg.2023347","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2023347","url":null,"abstract":"<p><strong>Introduction: </strong>The primary aims of the current nationwide study were to establish the lifetime and 12-month prevalence of consumption of illicit drugs and its correlates in the general population of Singapore.</p><p><strong>Method: </strong>A representative sample of 6509 Singapore residents (Singapore citizens and permanent residents) aged between 15 and 65 years were randomly selected for participation. Questionnaires were administered to assess the consumption of illicit drugs and collect information on correlates. All analyses were weighted to produce prevalence estimates for the consumption of drugs and other measured outcomes. Rao-Scott chi-square test and logistic regression analyses were performed to determine the association of sociodemographic and clinical characteristics with lifetime consumption of illicit drugs.</p><p><strong>Results: </strong>The study was completed with a response rate of 73.2%. The lifetime prevalence of consuming illegal drugs was 2.3% (95% confidence interval [CI] 1.9-2.8) (n=180). Compared to individuals aged 15-34, those aged 50-65 (odds ratio [OR] 0.3, 95% CI 0.2-0.7) had lower odds of lifetime drug consumption. Current smokers (OR 4.7, 95% CI 2.7-8.3) and ex-smokers (OR 5.9, 95% CI 3.2-11.1) had significantly higher odds of lifetime drug consumption than non-smokers. Individuals with hazardous alcohol use (OR 3.3, 95% CI 1.7-6.5) had higher odds of lifetime drug consumption than those without hazardous alcohol use.</p><p><strong>Conclusion: </strong>This is the first nationwide study to examine the prevalence of illicit drug consumption in the general population of Singapore. The results highlight the need to increase awareness of drug consumption in Singapore, especially among parents, teachers, healthcare workers and others who work with young people.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of tramadol misuse: A pilot multicentre cross-sectional survey in Singapore.","authors":"Henry W Chua, Lydia W Li, Daphne Yen, Diana Xh Chan, Christopher W Liu","doi":"10.47102/annals-acadmedsg.2023315","DOIUrl":"10.47102/annals-acadmedsg.2023315","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}