Background: Despite rapid advances in acute ischaemic stroke (AIS) management, many healthcare professionals (HCPs) might not be aware of the latest recommended management of AIS patients. Therefore, we aimed to determine the level and factors associated with AIS management knowledge among Malaysian HCPs. Methods: This cross-sectional online questionnaire study was conducted nationwide among 627 HCPs in Malaysia using the Acute Stroke Management Questionnaire (ASMaQ). Multiple logistic regression was used to predict the relationship between the independent variables (age, gender, years of service, profession, work setting, work sector, seeing stroke patients in daily practice, and working with specialists) and the outcome variable (good vs poor knowledge). Results: Approximately 76% (95% CI [73–79%]) of HCPs had good overall knowledge of stroke. The highest proportion of HCPs with good knowledge was noted for General Stroke Knowledge (GSK) [88.5% (95% CI [86–91%])], followed by Advanced Stroke Management (ASM) [61.2% (95% CI [57–65%])] and Hyperacute Stroke Management (HSM) [58.1% (95% CI [54–62%])]. The odds of having poor knowledge of stroke were significantly higher among non-doctor HCPs [adjusted OR = 3.46 (95% CI [1.49–8.03]), P = 0.004]; among those not seeing stroke patients in daily practice [adjusted OR = 2.67 (95% CI [1.73–4.10]), P < 0.001]; and among those working without specialists [adjusted OR = 2.41 (95% CI [1.38–4.18]), P = 0.002]. Conclusions: Stroke education should be prioritised for HCPs with limited experience and guidance. All HCPs need to be up-to-date on the latest AIS management and be able to make a prompt referral to an appropriate facility. Therefore, more stroke patients will benefit from advanced stroke care.

As Malaysia undergoes a demographic transformation of population aging, the prevalence of dementia is expected to rise, posing a major public health threat issue. Early screening to detect cognitive impairment is important to implement appropriate clinical interventions. The Visual Cognitive Assessment Test (VCAT) is a language-neutral cognitive assessment screening tool suitable for multilingual populations. This study was aimed to validate the VCAT screening tool for the detection of cognitive impairment amongst the population of Malaysia. A total of 184 participants were recruited, comprising 79 cognitively healthy participants (CHP), 46 mild cognitive impairment (MCI) patients, and 59 mild dementia (Alzheimer’s disease and Vascular Dementia) patients from five hospitals between May 2018 and December 2019 to determine the usefulness of VCAT. Diagnostic performance was assessed using area under the curve (AUC), and receiver operating characteristic (ROC) analysies was performed to determine the recommended cutoff scores. ROC analyses for the VCAT was comparable with that of MoCA (Montreal Cognitive Assessment) in differentiating between CHP, MCI, and mild dementia (AD and VaD) participants. The findings of this study suggest the following optimal cutoff score for VCAT: Dementia 0–19, MCI 20–23, Normal 24–30. The mean ± SD time to complete the VCAT was 10.0 ± 2.75 min in the CHP group and 15.4 ± 4.52 min in the CI group. Results showed that 76.0% of subjects thought that the instructions in VCAT were similar or easier to understand compared with MoCA. This study showed that the VCAT is a valid and useful screening tool for patients with cognitive impairment in Malaysia and is feasible to be used in the clinical settings.

Evidence-based medicine (EBM) plays a critical role in improving clinical decision-making and patient outcomes. We aimed to determine the knowledge, practice, and facilitating factors of EBM and the associated factors of EBM knowledge and practice among Malaysian doctors. A cross-sectional study with a nationwide online survey was conducted from June to November 2022 among Malaysian doctors. The survey assessed doctors' knowledge (K), practice (P), and facilitating factors (F) for EBM (collectively referred to as KPF) using the preexisting validated Evidence-Based Medicine Questionnaire (EBMQ). Higher scores indicated better knowledge, practice, and facilitating factors for EBM implementation. The KPF percentage scores were categorised into high (> 80%), moderate (60–79%), and low (< 59%). The Pearson correlation coefficient was used to assess the correlation between knowledge, practice, and facilitating factors. The differences in knowledge and practice scores by gender, designation, workplace, work sector, EBM workshop participation, research experience, publication, and level of facilitating factors after adjusting for years of service were analysed using multi-factorial multivariate analysis of covariance (MANCOVA). Among 409 doctors, 53.8% of doctors had a moderate level of knowledge, while about two-thirds demonstrated a higher level of practice (67.2%) and a moderate level of facilitating factors (67.0%). About 18% and 12% of doctors had low levels of knowledge and facilitating factors, respectively. Only 0.5% had low EBM practice. A positive and significant correlation among knowledge, practice, and facilitator scores was noted (P < 0.001). Doctors with prior research experience, high facilitating factors, and EBM workshops attendance had higher EBM knowledge scores (all P < 0.001). Specialists (P = 0.029) and doctors with high facilitating factors (P < 0.001) had higher EBM practice scores. Malaysian doctors reported a high level of EBM practice despite moderate knowledge and facilitating factors. This suggests a strong willingness to integrate EBM into clinical practice. EBM workshops may help doctors gain further knowledge. Stakeholders should address the barriers that exist at the individual, institutional, and health system levels to strengthen the implementation of EBM.