Question formulation(pico)(2)
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This document discusses how to formulate a well-built clinical question using the PICO framework to guide evidence-based decision making. It explains that a good clinical question should include four key elements: the patient population, the intervention, a comparison, and the outcomes. Defining each of these elements in a clear and specific way helps ensure the clinical question can be answered by relevant evidence. The document provides guidance on how to describe each PICO element in a structured clinical question.
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PICO question
This document discusses developing PICO questions to help formulate clinical questions. It provides background on distinguishing background and foreground questions. The PICO framework is introduced as a method to structure clinical questions into four components: P (patient/population), I (intervention), C (comparison), and O (outcome). Examples are provided to demonstrate how to formulate a PICO question from a clinical scenario. The question types that can be addressed through PICO questions are also outlined.
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PICO Research Question
1. The PICO model is used to structure clinical questions and formulate answerable research questions. It breaks questions down into four key elements - Population, Intervention, Comparison, and Outcome.
2. A good research question will be clearly linked to the overall project goal, allow identification of the target population and study subjects, and guide the appropriate choice of study design and data collection methods.
3. The example discusses using the PICO model to formulate the question "What evidence is there to support ‘honey’ therapy for the treatment of neck wound dehiscense rather than conventional debridement therapies?"
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- Time trends which can be secular (long-term), periodic (interruptions to secular trends), or seasonal (cyclical yearly variations).
- Place patterns looking at geographic distributions of disease.
- Person characteristics of those affected such as age, sex, occupation.
Descriptive studies are the first step in understanding diseases and include case reports, case series, and cross-sectional prevalence studies.
Cross sectional study
This document describes a cross-sectional study and its methodology. A cross-sectional study involves collecting data on exposure and outcome variables from a population at a single point in time. The document discusses the differences between descriptive and analytical cross-sectional studies. Descriptive studies measure prevalence, while analytical studies test associations between exposures and outcomes. The document provides examples of cross-sectional study design, biases, advantages, and guidelines for evaluating validity.
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4. level of evidence
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Randomized Controlled Trial
This document discusses different types of epidemiological studies, with a focus on experimental studies and randomized controlled trials (RCTs). It describes the key features of RCTs, including that they: (1) involve randomly allocating subjects into study and control groups to receive or not receive an intervention, (2) aim to control for confounding factors through randomization, and (3) are considered the gold standard for evaluating interventions due to their ability to minimize bias. The document outlines the basic steps in conducting an RCT, from developing a protocol to randomization, intervention, follow-up, assessment and analysis. It also discusses types of RCTs and their importance in evaluating treatments, prevention, risk factors and more.
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PICO question
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PICO Research Question
1. The PICO model is used to structure clinical questions and formulate answerable research questions. It breaks questions down into four key elements - Population, Intervention, Comparison, and Outcome.
2. A good research question will be clearly linked to the overall project goal, allow identification of the target population and study subjects, and guide the appropriate choice of study design and data collection methods.
3. The example discusses using the PICO model to formulate the question "What evidence is there to support ‘honey’ therapy for the treatment of neck wound dehiscense rather than conventional debridement therapies?"
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The document discusses descriptive epidemiology and provides definitions and examples. Descriptive epidemiology studies the occurrence and distribution of disease. It describes the who, where, and when of diseases. Key terms discussed include:
- Time trends which can be secular (long-term), periodic (interruptions to secular trends), or seasonal (cyclical yearly variations).
- Place patterns looking at geographic distributions of disease.
- Person characteristics of those affected such as age, sex, occupation.
Descriptive studies are the first step in understanding diseases and include case reports, case series, and cross-sectional prevalence studies.
Cross sectional study
This document describes a cross-sectional study and its methodology. A cross-sectional study involves collecting data on exposure and outcome variables from a population at a single point in time. The document discusses the differences between descriptive and analytical cross-sectional studies. Descriptive studies measure prevalence, while analytical studies test associations between exposures and outcomes. The document provides examples of cross-sectional study design, biases, advantages, and guidelines for evaluating validity.
Cross sectional study
Cross-sectional studies examine the relationship between a disease and exposure in a population at a single point in time. They provide a snapshot of disease prevalence and exposure prevalence simultaneously. While they can describe disease burden and identify potential risk factors, the temporal relationship between exposure and disease is unclear since they involve simultaneous rather than longitudinal measurement.
4. level of evidence
The document discusses various frameworks for rating the level of evidence in studies, including the NHMRC, GRADE, Oxford Centre for Evidence-Based Medicine, and Sackett scales. It outlines the different levels in each scale, with the highest levels reserved for systematic reviews and randomized controlled trials. The lowest levels include case series, case reports, and expert opinion without critical analysis. It also provides guidance on selecting the appropriate study design based on different types of clinical questions regarding therapy, diagnosis, etiology, prognosis, prevention, or costs.
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This document discusses cross-sectional studies, which measure exposure and health outcomes at the same point in time. It notes that cross-sectional studies can be descriptive, providing prevalence rates, or analytic, examining associations between exposures and outcomes. While able to generate hypotheses, cross-sectional studies cannot determine causation due to their inability to assess temporal relationships. The document also briefly touches on case reports and case series, which lack control groups for formally assessing relationships.
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This document provides an overview of randomized controlled trials (RCTs). It begins with an introduction to RCTs, describing them as the gold standard for evaluating health care technologies. It then covers key aspects of designing and conducting RCTs, including developing a protocol, selecting and randomizing study populations, manipulating variables, follow-up, assessment, types of RCTs based on design and use, and ethical considerations. RCTs aim to provide scientific evidence of causal relationships and evaluate interventions through random assignment and control groups.
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- Disadvantages: Expensive, long follow up needed
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The document outlines different epidemiological study designs including experimental, observational, and quasi-experimental designs. It provides examples of randomized controlled trials, cohort studies, case-control studies and other designs, discussing their
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Dept of Pharmacology
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2) Potential benefits of blinding include less psychological or physical bias in participants, better compliance, and less bias in outcome assessments.
3) Types of blinding include non-blinded (where all know assignments), single-blinded (one group remains unaware), and double-blinded (participants, investigators, and assessors remain unaware). Placebos are often used to maintain blinding.
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This document provides an overview of evidence-informed decision making and critical appraisal for nursing practice. It defines evidence-informed decision making and its importance for nursing. It also outlines the steps of evidence-informed decision making including formulating a focused, answerable question using PICO/PICOT, searching for and collecting the best evidence, and critically appraising the literature. Criteria for critically appraising different study designs are discussed, including intervention studies. The importance of critical appraisal for nursing practice, policy, and research is emphasized.
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Strategies and tactics for overcoming potential barriers to collecting and effectively using PROMs.
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Question formulation(pico)(2)
- 2. Asking the right question is a difficult skill to learn, yet it is fundamental to the evidence- based decision-making process. This process almost always begins with a patient question or problem. A "well-built" question should include four parts, referred to as PICO.
- 3. Translate clinical problem into a structured question and identify the key concepts – be specific. ◦ Population (patient or problem) ◦ Intervention ◦ Comparison ◦ Outcome
- 4. Define disease/condition Severity, stages of condition Setting (hospital, community) Age range, Gestation Other illnesses Exclusions?
- 5. Define intervention – Dose, duration, frequency, route – Drugs - any in a class? – Define optional and essential elements of the intervention – who, how, when? – how easy would these be to implement in clinical practice?
- 6. Specify the comparison • Placebo • Nothing • Usual care • Other intervention –best evidenced based alternative
- 7. • What outcomes are important, and to whom? • Have scales or measurement tools been validated? • Use of surrogate outcomes - related to the “real outcome” • Primary vs. secondary
- 8. Once you have identified a patient problem and defined your question using PICO, you are ready to find the most current valid evidence.
- 9. Purpose Statement: The purpose of this evidence based project is to determine the perceptions of anesthesia providers regarding the use of a disposable laryngoscope blade, their frequency of use, their evaluation of ease of use, and any complications encountered when using the disposable blade before and after an in-service program designed to increase use of disposable blades. PICO: In patients requiring intubation (P), how does the use of a disposable laryngoscope blade (I) compared with a reusable laryngoscope blade (C) affect ease of use, complications, and cost (O)? (P) Patient, Population, Problem- Patients requiring intubation (I) Intervention-Disposable Laryngoscope Blades (C) Comparison-Reusable Laryngoscope Blades (O) Outcome –Ease of use, complications, and cost