WhoWe Are
The Centre for Clinical Epidemiology (CCE) undertakes epidemiology research which aims to bridge the gap between research, clinical practice and policy development in the best interest of patient & public health.
We believe in creating sustainable research collaborations and developing efficient capacity building to further enrich and enhance the development of our organisation.
OrganizationChart
InvestigatorsHighlight
Head, Centre for Clinical Epidemiology (CCE)
Email: amyhwong@crc.gov.my
BMBS (Nottingham, UK), MSc Epidemiology (Utrecht, Netherlands), PhD Epidemiology (Utrecht, Netherlands)
Areas of interest: Application of clinical epidemiology principles & methods, cardiovascular care in particular stroke
Awards and achievements:
- Excellent Service Award, Ministry of Health Malaysia (2013, 2023)
- Best Publication Award for Young Investigators, Malaysian Society of Neurosciences 2018
- Secured Erasmus+ mobility grant in collaboration with Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (2012-2022, 2024-2025)
Dr. Amy Hwong is a clinical epidemiologist and the current head of CCE, as well as an associated scientist with Julius Global Health, University Medical Center Utrecht in the Netherlands.
Throughout the years, she has accrued vast experience in different clinical research aspects ranging from study design planning to statistical analysis and manuscript writing. She has published numerous articles in peer-reviewed journals and has also presented in a myriad of local and international conferences.
Apart from her specific interest in research to improve delivery of cardiovascular care among stroke patients, her current position as the Head of Centre has broadened her scope of clinical epidemiology work into other disease areas such as cancer and palliative care.
Research Highlights
- One of the few who first applied the conduct of data linkage across national health administrative data to estimate health metrics in Malaysia. Outputs on hospitalized incidence, 28-days all-cause mortality, and readmission rates for stroke in Malaysia were published
- Applied a case study approach to identify challenges in the provision of intravenous stroke thrombolysis in Malaysia as part of the effort to improve the rates of the therapy
Recent Publications
Pharmacist
Email: tehhsh@crc.gov.my
MPharm (Hons) (Nottingham, UK), MSc Pharm. Analysis (UKM, Malaysia)
Areas of interest: Epidemiology, Public Health especially related to cancer and cardiovascular, Data analysis, Application of health economics
Awards and achievements:
- Excellent service award, Ministry of Health (2015, 2023)
- Best Poster Award, 13th National Conference for Clinical Research (NCCR), 2020
- Best Poster Award, 14th National Conference for Clinical Research (NCCR), 2021
- Oral Presenter 14th Asian Conference on Pharmacoepidemiology (ACPE14), 2022
- Latihan Dalam Perkhidmatan (Luar Negara), Ministry of Health Malaysia- Utrecht University, 2023
- Active peer reviewer for BMC and PharmacoEconomics journals
A research pharmacist with interests in the field of epidemiology, particularly in understanding the distribution of diseases and their economic implications for public health. She also demonstrates a keen interest in data wrangling and analysis using R, leveraging these skills to extract meaningful insights from complex datasets.
With a solid background in project management, Hoon Shien brings invaluable expertise to her current role. Having overseen clinical trials in the past, she now extends her expertise to epidemiological studies, ensuring robust data collection and analysis to track and mitigate disease patterns effectively.
Research Highlights
- Encompasses both epidemiology and application of health economics, reflecting a broad interdisciplinary approach to addressing public health challenges. E.g in the economic evaluation of Nirmatrelvir/Ritonavir among adults against hospitalization during the Omicron-dominated period in Malaysia, providing insights into real-world treatment effectiveness.
- International work with the Health Economics Research Centre at Oxford University, employing innovative methods such as the Discrete Choice Experiment to explore healthcare decision-making processes.
Recent Publications
OurongoingrecentResearch Projects
Appeal Preferences in Breast Cancer Screening Health Messages: A Cross-Sectional Study in Malaysia
NMRR ID-24-01707-QAC
The general objective of the study is to explore the preference for appeals in health messages to promote breast cancer screening. This cross-sectional study will employ a self-administered anonymous web-based survey in Malaysia, and the entire study will be conducted from May 2024 to October 2025. The study targets eligible Malaysian women aged 18 and above, utilising snowball sampling through platforms such as WhatsApp, Telegram, Facebook, Instagram, Twitter, and LinkedIn. Eligible participants will navigate an online screening criteria and informed consent page before completing the survey
Contact: Dr. Loo Ching Ee
chingee@crc.moh.gov.my
Epidemiology of Thalassemia in Sabah
NMRR ID-24-01607-9UB
This is a cross-sectional study to describe the epidemiology of thalassemia in Sabah in the aspects of disease burden, disease outcome, blood transfusion, transplant, treatment, complications, quality of life and public health screening efforts. This study also intends to compare the aforementioned Sabah epidemiological parameters to that of Malaysia.
Contact: Dr. Hadhinah
hadhinahp@moh.gov.my
Cardiovascular Risk Prediction in People Living with HIV (Card-HIV)
NMRR ID-23-01983-QSM
This is a retrospective cohort study which is constructed via linking and extracting data sourced from Hospital Sg Buloh, the Malaysian Antiretroviral Cohort (MATCH), national hospitalisation database, and the national death registry. The main aims of this study are to evaluate the performance of available CV risk prediction models and to understand the CV disease burden among PLHIV in Malaysia.
Contact: Dr. Amy Hwong
amyhwong@moh.gov.my
mHealth Behavioural Intervention to Increase Breast Cancer Screening Rates Among Members of the Public (m-BLISS-B)
NMRR ID-22-01338-NBF
Late-stage presentation of breast cancer cases are on the rise in Malaysia. Encouraging breast screening practices can assist in early breast cancer detection. Behavioural interventions on mobile communication platform is a viable strategy and potentially effective at motivating breast cancer screening and breast self-examination (BSE) practices among the public. Hence, we plan to investigate the effectiveness of an mHealth behavioural intervention in the form of a health communication programme using a social messaging application to motivate breast cancer screening and breast self-examination practices among the public.
The study is divided into 2 phases. Phase 1 involves a mixed method study design. A scoping review will be conducted to compile studies which addressed barriers and facilitators to practice BSE and breast cancer screening in Malaysia. Study team will then conduct a series of focus group discussions or interviews to explore the favoured characteristics of a health communication programme that promotes breast cancer screening, and is delivered via a social messaging application, the barriers and facilitators for breast self-examination and breast cancer screening, and factors which could nudge women to adopt these behaviours.
Findings from Phase 1 will contribute towards content development and health communication programme design for Phase 2. Phase 2 uses a randomised controlled experiment study design among Malaysian women adults aged 35 and above. They will be randomised to be enrolled in a health communication programme to receive either messages designed using behavioural science, or messages that are already present in the public from official sources. Another group acting as the control will not receive any messages during the entire study period. Subjects will be assessed using a questionnaire at baseline and during a follow up period.
Contact: Nicholas Yee Liang Hing
nicholas.hingyl@gmail.com
Multicentre Clinical Epidemiological Study of Female Breast Cancer in a Multi-ethnic Malaysian Setting (Epi-Can)
NMRR ID-22-01338-NBF
Epi-Can is a multicentre retrospective cohort study that involves seven of the Ministry of Health (MOH) hospitals in Malaysia. This study aimed to determine the nature of breast cancer patients’ presentation, diagnosis, management of treatment, treatment-induced cardiovascular complications and survival while describing the variation across age, socioeconomic, geographic regions, ethnic differences and its trend over time in Malaysia. The results of this study will aid in observing secular changes as well as long-term outcomes for breast cancer patients in real-world clinical practice.
Contact: Shridevi Subramaniam
shridevi@crc.gov.my
Identifying Quality Indicators for End-Of-Life Cancer Care in Malaysia: A modified Delphi study (QIEOL)
NMRR ID-22-02608-RJQ
This study aims to develop a set of quality indicators (QIs) that evaluate the quality of end-of-life (EOL) care for cancer patients by the means of literature review and the consensus of expert opinions which are suitable for the Malaysian context. A repeated cross-sectional study utilising modified Delphi survey is used to obtain consensus from experts (i.e. healthcare professionals involved in EOL care services) on the development of QIs in EOL cancer care.
Contact: Dr. Gabrielle Wong
wwjun@crc.moh.gov.my
Trends in Place of Death for People with Life-limiting Illnesses in Malaysia (FAREWELL)
NMRR ID-22-00809-ODI
This is a secondary data analysis utilizing national mortality data of deaths between 2005 to 2019 to estimate the trends and and factors associated with place of death (PoD) among patients who died from life-limiting illnesses. Subsequently, to project future PoD care setting by 2030.
Contact: Dr. Gabrielle Wong
wwjun@crc.moh.gov.my
Post-COVID-19 Vaccination Immunogenicity Surveillance Among Healthcare Workers (VIGILANCE)
NMRR ID-21-65-58212
This was a prospective cohort study of healthcare workers who received COVID-19 vaccination. The conduct of this study was incorporated into the vaccination rollout plan. All eligible healthcare workers who received the COVID-19 vaccination between 1/3/2021 to 31/5/2021 were recruited. Enrolled participants were required to answer a self-administered questionnaire upon recruitment. A baseline serum sample was taken before the first dose of vaccination. All participants were followed up for two years.
Contact: Yang Sulan
sulanyang218@gmail.com
Malaysian Delays in Diagnosis of Cancer and Initiation of Treatment Study (DEDICATE)
NMRR ID-19-727-47742
This is a multicentre cross-sectional study on the timeliness of cancer diagnosis and treatment for breast, colorectal, nasopharyngeal, and cervical cancers in Malaysia.
Contact: Dr. Loo Ching Ee
chingee@crc.moh.gov.my
The Impact of Strategies for Mitigating Delays and Disruptions in Cancer Care due to COVID-19 Pandemic: A Systematic Review
RSCH ID-23-01882-ZED
This review explored the mitigation strategies that were adopted and examined their impact on cancer care during the COVID-19 pandemic.
Contact: Dr. Loo Ching Ee
chingee@crc.moh.gov.my
The Impact of the COVID-19 Pandemic on Delays and Disruptions in Cancer Care: A Systematic Review
RSCH ID-23-01893-RCK
This is a systematic review consolidating and critically assess the magnitude and impact of cancer services delays and disruptions including screening, diagnostic procedures, diagnosis, treatment, and palliative care during the COVID-19 pandemic.
Contact: Dr. Loo Ching Ee
chingee@crc.moh.gov.my
Factors Influencing Physicians' to Conduct Cardiovascular Risk Assessments Among Cancer Patients: A Systematic Review (I-CARE)
NMRR ID-22-01252-KPN
This is a systematic review that consolidates factors influencing the implementation of cardiovascular risk assessment among the cancer population from existing literature and explores its relationships to highlight key domains that need to be addressed to implement these risk assessment programs in clinical practice.
Contact: Teh Hoon Shien
tehhsh@crc.moh.gov.my
Access to Hyperacute Stroke Care in Malaysia
NMRR ID-19-3145-51552
This is a multiple method study using a multiple case study methodology. The main aim of this study is to explore the experiences and challenges faced by the healthcare providers in the provision of intravenous thrombolysis for the management of ischemic stroke in Ministry of Health, Malaysia.
Contact: Dr. Amy Hwong
amyhwong@moh.gov.my
List of Publications associated with CCE
- Palliative care in Malaysia according to illness trajectories; a retrospective 11-year estimate
- Nicholas Yee Liang Hing, Su Lan Yang, Cindy Cy Oun Teoh, Chin Tho Leong, Yuan Liang Woon, Richard Boon Leong Lim
- Global review of COVID-19 mitigation strategies and their impact on cancer service disruptions
- Richa Shah, Ching Ee Loo, Nader Mounir Hanna, Suzanne Hughes, Allini Mafra, Hanna Fink, Ethna McFerran, Montse Garcia, Suryakanta Acharya, Oliver Langselius, Clara Frick, Jean Niyigaba, Nwamaka Lasebikan, Julia Steinberg, Richard Sullivan, Freddie Bray, André Michel Ilbawi, Ophira Ginsburg, Karen Chiam, Jonathan Cylus, Michael Caruana, Michael David, Harriet Hui, Karen Canfell, Isabelle Soerjomataram
- Factors influencing presentation delay among cancer patients: a cross-sectional study in Malaysia
- Tshewang Gyeltshen, Hoon Shien Teh, Ching Ee Loo, Nicholas Yee Liang Hing, Wei Yin Lim, Shridevi Subramaniam, Wen Jun Wong, Zoie Shui-Yee Wong, Wen Yea Hwong
- Economic evaluation of nirmatrelvir/ritonavir among adults against hospitalization during the Omicron dominated period in Malaysia: a real-world evidence perspective
- Ee Vien Low, Hoon Shien Teh, Nicholas Yee Liang Hing, Suresh Kumar Chidambaram, Mohan Dass Pathmanathan, Wee Ric Kim, Wei Jia Lee, Zhi Wei Teh, Maheshwara Rao Appannan, Shahanizan Mohd Zin, Faizah Muhamad Zin, Samha Bashirah Mohamed Amin, Mastura Ismail, Azah Abdul Samad, Kalaiarasu M. Peariasamy
- Trends in cataract surgery and healthcare system response during the COVID-19 lockdown in Malaysia: lessons to be learned
- Amanda Wei-Yin Lim, Chin Tho Leong, Mohamad Aziz Salowi, Yvonne Mei Fong Lim, Wen Jun Wong, Wen Yea Hwong
- Identifying factors in the provision of intravenous stroke thrombolysis in Malaysia: a multiple case study from the healthcare providers' perspective
- Wen Yea Hwong, Sock Wen Ng, Seng Fah Tong, Norazida Ab Rahman, Wan Chung Law, Sing Keat Wong, Santhi Datuk Puvanarajah, Aisyah Mohd Norzi, Fiona Suling Lian, Sheamini Sivasampu
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Centre for Clinical Epidemiology (CCE)
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