Brilliant!
Guess I shall have to start working on MATADR - or would that just be
too much bull? :-)
Rgds
Andrew
Martin Dawes, Dr. said the following on 24/02/2009 12:20:
> Andrew
> You missed PECODR
> We have included the duration and the results.
> For your childhood cancers
> D - over 5 years
> R - paper includes an absolute risk increase in the results
>
> But the better we structure the question the more frustration we face when we hit the search engine. That is why we are working hard to develop a search engine (thanks to SSHRC) that utilizes the PECO(DR) elements in its strategy and hopefully will reduce this frustration.
>
> Martin
>
>
> On 24/02/2009 06:09, "Andrew Booth" <[log in to unmask]> wrote:
>
> Hi List
>
> I am a keen collector of PICO alternatives (and have invented a few quasi-humorous variants as well).
>
> Specifically for Qualitative Research the following may be relevant:
> SPICE (SETTING POPULATION INTERVENTION(Alternative=INTEREST, Phenomenon of) COMPARISON EVALUATION) as already mentioned
>
> PICOC (POPULATION INTERVENTION COMPARISON OUTCOMES CONTEXT) from Pettigrew and Roberts book
>
> ProPheT (PROBLEM, PHENOMENON, TIME)
>
> I reproduce my handout below in plain text. Word version available on request from the author!
>
> Formulating non-PICO questions
>
> Although the PICO formulation should apply easily to the majority of effectiveness questions and a great number besides you may encounter questions that are not easily accommodated within this particular framework. Below you will find a number of acceptable alternatives:
>
> Q. What if I have not identified an Intervention? A. PECO
> For non-intervention studies we suggest that you may find it helpful to replace Intervention (a planned procedure) with Exposure (an unintentional occurrence or happening).
> Population: Schoolchildren living near high voltage electricity pylons
> Exposure: Abnormally high electromagnetic fields
> Comparison: School children not living near pylons.
> Outcome: Incidence of Childhood cancers
> Q. What if I am interested in a social intervention? A. PICOC
> For interventions that are heavily dependent on context for their effectiveness we suggest the addition of C for Context to the standard PICO formulation.
> Population: Sexually active teenagers
> Intervention: Free provision of contraceptives
> Comparison: Other approaches to prevention of teenage pregnancy
> Outcome: Incidence of pregnancies and abortions
> Context: Predominantly Catholic countries
> Q. What if I have not identified a comparison? A. PIE
>
> 1. First check that you have not simply overlooked an implicit comparison (e.g. standard care, placebo, non-intervention etcetera)
> 2. Consider simply using the following framework:
>
> Problem: Patients with leg ulcers
> Intervention: Bandages
> Evaluation: Acceptability and patient satisfaction
> Q. What if I am interested in a Qualitative question? A. SPICE or ProPheT
> Setting: Industrialised cities in the developing world
> Perspective: Health workers
> Intervention/Interest: Needle Exchange schemes
> Comparison: None
> Evaluation: Acceptability
>
> Problem: Adolescents with Diabetes
> Phenomenon of Interest: Stigma associated with use of needles
> Time: Within a year of diagnosis
>
> Q. What other variations on PICO are there? A. PICOS and PICOT
> Population/Patient: Sexually active teenagers
> Intervention: Free provision of contraceptives
> Comparison: Other approaches to prevention of teenage pregnancy
> Outcome: Incidence of pregnancies and abortions
> Study Design: Cohort Studies
>
> Population/Patient: Sexually active teenagers
> Intervention: Free provision of contraceptives
> Comparison: Other approaches to prevention of teenage pregnancy
> Outcome: Incidence of pregnancies and abortions
> Time: Within a year of first sexual activity
>
>
>
>
>
>
>
>
>
>
>
> And some variations you definitely won't have heard of!:
> PEAHEN (Population, Exposure, Adverse Health Effects, Negative reactions; as alternative to PICOC)
> SugABABes (Suggested Approach, Best Alternative, Best compromise; as alternative to SPICE)
> PEAS (Problem, Experiment, Alternative, Setting; as alternative to PIE)
> SAPO (Setting, Approach, Primary Outcomes; as alternative to PICO)
>
>
> Andrew Booth 14/11/06
>
>
>
>
> EVIDENCE-BASED-HEALTH automatic digest system wrote:
>
> There are 4 messages totalling 985 lines in this issue.
>
> Topics of the day:
>
> 1. SV: Qualitative research and PICO
> 2. R: Basic question about diagnostic versus prognostic studies
> 3. SV: SV: Qualitative research and PICO
> 4. Basic question about diagnostic versus prognostic studies
>
> ----------------------------------------------------------------------
>
> Date: Mon, 23 Feb 2009 00:52:13 -0600
> From: "Dr. Carlos Cuello" <[log in to unmask]> <mailto:[log in to unmask]>
> Subject: Re: SV: Qualitative research and PICO
>
> --00032557570240316e046390713d
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> Content-Transfer-Encoding: quoted-printable
>
> Greetings
>
> wouldn't be better to consider the question into the frame of background vs
> foreground questions?
>
> If so, this would obviously be a background question.
> Presuming qualitative research is often use to explore topics or questions
> that usually cannot be answered by quantitative methods, for example, what
> are the reasons doctors prescribe more x therapy? Or which are the reasons
> patients do not take x drug, etc?
>
> Regards
>
>
>
>
> Carlos A. Cuello-Garc=EDa, MD
> Director, Centre for Evidence-Based Practice-Tecnologico de Monterrey
> Cochrane-ITESM coordinator. Professor of Paediatrics and Clinical Research
> Avda. Morones Prieto 3000 pte. Col. Doctores. CITES 3er. piso,Monterrey NL,
> M=E9xico. CP64710
> Phone. +52(81)88882154 & 2141. Fax: +52(81)88882019
> www.cmbe.net <http://www.cmbe.net>
>
> The content of this data transmission must not be considered an offer,
> proposal, understanding or agreement unless it is confirmed in a document
> signed by a legal representative of ITESM. The content of this data
> transmission is confidential and is intended to be delivered only to the
> addressees. Therefore, it shall not be distributed and/or disclosed through
> any means without the authorization of the original sender. If you are not
> the addressee, you are forbidden from using it, either totally or partially=
> ,
> for any purpose
>
> --00032557570240316e046390713d
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>
> <div>Greetings<br><br>wouldn't be better to consider the question into =
> the frame of background vs foreground questions?</div><div><br></div><div>I=
> f so, this would obviously be a background question.<br>Presuming qualitati=
> ve research is often use to explore topics or
> questions that usually cannot be answered by quantitative methods, for
> example, what are the reasons doctors prescribe more x therapy? Or wh=
> ich are the reasons patients do not take x drug, etc?<br><br>Regards<br><br=
>
>
>
> <br><br></div><br>Carlos A. Cuello-Garc=EDa, MD<br>Director, Centre for Ev=
>
>
>
> idence-Based Practice-Tecnologico de Monterrey <br>
> Cochrane-ITESM coordinator. Professor of Paediatrics and Clinical Research =
> <br>Avda. Morones Prieto 3000 pte. Col. Doctores. CITES 3er. piso,Monterrey=
> NL, M=E9xico. CP64710 <br>Phone. +52(81)88882154 & 2141. Fax: +52(81)8=
> 8882019 <br>
> <a href=3D"http://www.cmbe.net" <http://www.cmbe.net> >www.cmbe.net <http://www.cmbe.net> </a><br> <br>The content =
> of this data transmission must not be considered an offer, proposal, unders=
> tanding or agreement unless it is confirmed in a document signed by a legal=
> representative of ITESM. The content of this data transmission is confiden=
> tial and is intended to be delivered only to the addressees. Therefore, it =
> shall not be distributed and/or disclosed through any means without the aut=
> horization of the original sender. If you are not the addressee, you are fo=
> rbidden from using it, either totally or partially, for any purpose<br>
>
>
> --00032557570240316e046390713d--
>
> ------------------------------
>
> Date: Mon, 23 Feb 2009 08:46:10 +0100
> From: Barbani Federico <[log in to unmask]> <mailto:[log in to unmask]>
> Subject: R: Basic question about diagnostic versus prognostic studies
>
> Hi Simon.
> I heard a beautiful sentence about this matter: "the diagnosis (..) is =
> only
> a mental resting place for prognostic considerations and therapeutic
> decisions".
> (Wulff HR. Rational diagnosis and treatment. Oxford: Blackwell =
> Scientific
> Publications, 2nd Editions. 1981: 80, cited in: Alessandro Liberati, A.
> Addis, Luciana Ballini, Marco Bobbio, Massimo Brunetti, and Vittorio =
> Caimi.
> Etica, conoscenza e sanit=E0. Evidence-based medicine fra ragione e =
> passione,
> Roma:Il Pensiero Scientifico, 2005)
>
> I have long thought about this fascinating question.
> I came to the conclusion that substantially diagnosis and prognosis have =
> in
> deep the same meaning.
> Academically you can say that diagnosis is a wider concept and =
> encompasses
> symptoms, signs and test results, while prognosis is limited to how and =
> how
> long will be the life of the patient; so it is somewhat a part of =
> diagnosis.
> But for a patient's perspective to have a diagnosis is actually to have =
> a
> prognosis if no intervention is made and you let natural history go on.
> Simply in clinical practice prognosis is often placed in a following =
> time
> than diagnosis.
> Kind regrds
>
> dott. Federico Barbani
> Healthcare Purchasing Unit
> Health Authority Modena
> via San Giovanni del Cantone 23
> 41100 MODENA, Italy
> tel 059/435813 - 435731
>
> -----Messaggio originale-----
> Da: Evidence based health (EBH)
> [mailto:[log in to unmask]] Per conto di Steve Simon
> Inviato: venerd=EC 20 febbraio 2009 20.21
> A: [log in to unmask]
> Oggetto: Basic question about diagnostic versus prognostic studies
>
> Maybe this is a stupid question, but here goes.
>
> What is the difference between a diagnostic study and a prognostic=20
> study? Is it that diagnostic study examines one of more factors that can =
>
> help identify an already existing condition whereas a prognostic study=20
> examines one of more factors that can predict a future condition? Is it=20
> that diagnosis is targeted towards something bad (disease) while=20
> prognosis is targeted towards something good (recovery)? Or is it=20
> something else?
> --=20
> Steve Simon, Standard Disclaimer.
> Sign up for my brand new newsletter,
> The Monthly Mean, at www.pmean.com/news <http://www.pmean.com/news>
>
> ------------------------------
>
> Date: Mon, 23 Feb 2009 09:51:20 +0100
> From: Janet Harris <[log in to unmask]> <mailto:[log in to unmask]>
> Subject: SV: SV: Qualitative research and PICO
>
> This is a multi-part message in MIME format.
>
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> boundary="----_=_NextPart_002_01C99593.E6111D7A"
>
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> charset="iso-8859-1"
> Content-Transfer-Encoding: quoted-printable
>
> Kev, Craig and Carlos
> =20
> Thanks for the points.
> =20
> Re: Kev's point that Evaluation should be the results: The results =
> contained two headings: Perceived threat of the illness and Personal =
> control exercised by parents in response to the threat. I lumped these =
> under the term coping but it's probably better to keep the headings from =
> the article for accuracy.
>
> We also use Craig's PIC model, but have found that the different =
> definitions need some reinforcing. When people are accustomed to working =
> with RCTs and the traditional PICO, they tend to confuse Interventions =
> with Interest until they have had some practice.=20
>
> Craig, where do you place the FIndings in your acronym?
>
> Carlos asked 'wouldn't be better to consider the question into the frame =
> of background vs foreground questions? If so, this would obviously be a =
> background question.'
>
> Sackett et al (2000) characterizes background questions as 'who, what, =
> where, when, why and how' questions. This fits with qualitative =
> questions. And qualitative research can provide good background =
> information to inform systematic reveiw protocols.The Cochrane =
> Qualitative Research Methods Group is working on this now.=20
> =20
> Best wishes
> Janet=20
>
>
> ________________________________
>
> Fra: Evidence based health (EBH) p=E5 vegne av Craig Lockwood
> Sendt: s=F8 22.02.2009 23:33
> Til: [log in to unmask]
> Emne: Re: SV: Qualitative research and PICO
>
>
> Dear All,
> I have some affinity with the PICO format, its great in that existing =
> familiarity can assist with the teaching process, and with some =
> adaptation, I use the same approach for qualitative reviews.=20
> In usage, PICO becomes
> P Population
> I phenomena of Interest
> Co Context
>
>
> The phenomena of interest being (in a phenomenological example) the =
> lived experience. =20
>
> The question in action might look like
>
> "What is the lived experience of younger, disabled people residing in =
> long term care environments for older adults?"
>
> The population being younger people with a disability, the phenomena of =
> interest being their experiences and the context being that they are =
> living in an environment designed for older adults not living =
> independently. =20
>
> This is the format I use for teaching question development for =
> qualitative systematic review titles also; although I don't know of any =
> published reviews that describe their process of question development =
> that report using this approach.
>
> Kind regards
> Craig
>
>
>
> Craig Lockwood
> Associate Director / Research & Innovation
> The Joanna Briggs Institute
> Royal Adelaide Hospital
> North Terrace
> Adelaide, South Australia 5000
>
> p: +61 8 8303 4880 =20
> f: +61 8 8303 8280=20
>
> =20
>
>
>
>
>
>
> ________________________________
>
> From: Ornissa Naidoo <[log in to unmask]> <mailto:[log in to unmask]>
> Reply-To: Ornissa Naidoo <[log in to unmask]> <mailto:[log in to unmask]>
> Date: Mon, 23 Feb 2009 08:16:43 +1000
> To: "[log in to unmask]" <mailto:[log in to unmask]> =
> <[log in to unmask]> <mailto:[log in to unmask]>
> Subject: Re: SV: Qualitative research and PICO
>
> Greetings
> Very interesting debate,
> Yes I tend to use PICO,
> I agree with Janet:
> P: Parents
> I: Is not a manipulated intervention, but rather an event that occurs=20
>
> Hence I would use it as follows:
> P- Parents of preschool children who are acutely ill
> I- Parents beliefs/concerns
> C- Nil
> O- ( Not sure what you would eventually hope to achieve with the =
> information for eg:)
> - Less stressed patients of acutely ill preschool children ....
> =20
> Hope this helps
> Kind regards=20
> Ornissa Naidoo=20
>
>
>
>
>
>
>
> "k.hopayian" <[log in to unmask]> <mailto:[log in to unmask]> 23/02/2009 7:15 am >>>
>
>
>
>
>
> Hello Janet,
> Thanks for that. Yes, Booth and Brice?s SPICE structure does seem well =
> suited although it was developed with information services/librarians? =
> situation in mind. May I bounce back a few things for you to consider?
> 1 In teaching, it is good to have consistency so before accepting a new =
> tool, I would want to be sure that the old one has more disadvantages =
> than advantages (your ref to shoe horning points to a disadvantage).
> 2 PICO of course is not just for interventions, it works with diagnostic =
> and prognostic questions too (its suitability as an acronym has been =
> debated here before)
> 3 I think the Evaluation in SPICE as used below should actually be the =
> parents? beliefs and concerns about children becoming ill ? these are =
> the results.=20
>
> Kev
>
> Dr Kev (Kevork) Hopayian MD FRCGP
> GP Tutor
> Postgraduate Medical Centre
> Ipswich Hospital
> Ipswich
> Suffolk
>
> -------on 22/02/2009 17:59, Janet Harris at [log in to unmask] =
> <about:[log in to unmask]> wrote:
>
>
>
> Hi Kev
> =09
> PICO is good when you want to compare interventions and outcomes but =
> it's difficult to shoehorn qulaitative questions into this format.. =
> Qualitative questions explore perceptions of health issues, attitudes =
> toward interventions, experiences with interventions, and acceptability =
> of outcomes. They may compare diverse views and experiences across =
> different people but the comparison isn't manipulated by putting people =
> into different groups.=20
> =09
> An alternative format suggested b Booth & Brice (2003) is SPICE=20
> Setting: of the research
> Perspective: of those who are experiencing the intervention or the =
> situation of interest
> Intervention/Phenomena of Interest: the intervention or the phenomenon =
> that is being experienced
> Comparison: may be with those who do not receive the intervention or =
> experience the phenomenon
> Evaluation. What is being explored or evaluated in the study
> =09
> Going back to your article, it could be formatted like this:=20
> =09
> =09
> S: Disadvantaged inner city community
> P: Parents =20
> I: Acutely ill preschool children=20
> C: None
> E: .Coping when young children become acutely ill
> =20
> All elements are not always present - it depends on the question. =20
> =20
> You could alternatively formulate it as a PO, PI or PIO keeping in mind =
> that your definitions for PIO are a bit different e.g.
> P: Parents
> I: Is not a manipulated intervention, but rather an event that occurs =
> - acute illness in preschool children
> =20
> Hope that helps.
> =20
> Best wishes
> Janet
> =20
> Janet Harris
> Associate Professor
> University College Bergen
> Centre for Evidence Based Practice
> M?llandahlsveien 6
> Bergen 5009
> Norway
> =20
> =09
> =09
> ________________________________
>
> Fra: Evidence based health (EBH) p? vegne av Padmanabhan badrinath
> Sendt: s? 22.02.2009 16:17
> Til: [log in to unmask] =
> <about:[log in to unmask]>=20
> Emne: Qualitative research and PICO or PECOT & CASP checklists
> =09
> Dear Kev,
> =09
> A very good afternoon and early spring greetings from the East of =
> Englnd.
> =09
> A quick look at the CASP worksheets for the RCT and qualitative =
> desingns shows that first question is very different.=20
> CASP checklist for RCT available at
> http://www.phru.nhs.uk/Doc_Links/rct appraisal tool.pdf=20
> =09
> The first question is:=20
> =09
> Did the study ask a clearly-focused question?=20
> =09
> Consider if the question is ?focused? in terms of:=20
> ? the population studied=20
> ? the intervention given=20
> ? the outcomes considered
> =09
> CASP checklist for qualitative study available at=20
> http://www.phru.nhs.uk/Doc_Links/Qualitative Appraisal Tool.pdf=20
> =09
> The first question is:
> =09
> Was there a clear statement of the aims of the research?=20
> =09
> Consider:=20
> ? what the goal of the research was=20
> ? why it is important=20
> ? its relevance
> =09
> It appears that the PICO format is more suited for therapy questions.=20
> =09
> You might also find this paper by Huang et al of interest.=20
> =09
> Evaluation of PICO as a Knowledge Representation for Clinical Questions
> http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3D1839740=20
> =09
> "Our study shows that the PICO framework is best suited for =
> representing therapy questions, and considerably less-suited for =
> diagnosis, etiology, and prognosis questions. In some cases, it is =
> difficult to encode certain question classes without modifying the =
> existing PICO structure or introducing counterintuitive elements. Given =
> that the PICO framework is a well-established tool for formulating =
> clinical queries, any limitations of the framework itself could =
> potentially impact the quality of clinical evidence retrieved under its =
> guidance. This study reveals a number of challenges associated with PICO =
> analysis, which will serve as a basis for refining the principles of =
> clinical query formulation".
> =09
> Warm regards & very best wishes,
> =09
> Badri
> =09
> Dr P Badrinath MD BS M.Phil MPH FFPH PhD (Cantab) Consultant in Public =
> Health Medicine & Affiliated Clinical Lecturer Suffolk PCT & University =
> of Cambridge Rushbrook house, Paper mill lane, Bramford, Ipswich, IP8 =
> 4DE, Suffolk, UK http://myprofile.cos.com/badrishanthi=20
> =09
> =09
> =20
> > Date: Sun, 22 Feb 2009 10:08:25 +0000
> > From: [log in to unmask] =
> <about:[log in to unmask]>=20
> > Subject: Qualitative research and PICO or PECOT
> > To: [log in to unmask] =
> <about:[log in to unmask]>=20
> >=20
> > Does anyone have experience of setting the research question in a
> > qualitative study into the PIO or PICO or PECOT format? It seems =
> possible to
> > do so but I have not seen it done.
> > P is easy to identify but the E or I and O less so. There is =
> sometimes a C
> > but more often not.
> > For example, in a study "To identify and explore parents' concerns =
> when
> > preschool children become acutely ill."
> > http://www.bmj.com/cgi/content/full/313/7063/983
> > P =3D parents' of preschool children
> > E or I =3D children develop an acute illness (note - this does not =
> imply the
> > children have acute illness during the study, rather the parents =
> consider
> > their experience)
> > O =3D their beliefs and concerns.
> > So it can be done but my questions to the group are:
> > 1 Any views on using PIO/PICO in this situation? Does it add anything =
> of
> > value to our appreciation of the paper over and above a narrative =
> expression
> > of the research question (as in the title above)?
> > 2 Do you have experience of doing so? Could you tell us more?
> > --=20
> > B/W, Kev Hopayian
> =09
> =09
>
>
>
>
> --=20
>
>
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> charset="iso-8859-1"
> Content-Transfer-Encoding: quoted-printable
>
> <HTML dir=3Dltr><HEAD><TITLE>Re: SV: Qualitative research and =
> PICO</TITLE>=0A=
> <META http-equiv=3DContent-Type content=3D"text/html; charset=3Dunicode">=0A=
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> <DIV id=3DidOWAReplyText53613 dir=3Dltr>=0A=
> <DIV dir=3Dltr><FONT face=3DArial color=3D#000000 =
> size=3D2>Kev, Craig and Carlos</FONT></DIV>=0A=
> <DIV dir=3Dltr><FONT face=3DArial size=3D2></FONT> </DIV>=0A=
> <DIV dir=3Dltr><FONT face=3DArial size=3D2>Thanks for the =
> points.</FONT></DIV>=0A=
> <DIV dir=3Dltr><FONT face=3DArial size=3D2></FONT> </DIV>=0A=
> <DIV dir=3Dltr><FONT face=3DArial size=3D2>Re: Kev's point that =
> Evaluation should be the results: The results contained two =
> headings: Perceived threat of the illness and Personal control =
> exercised by parents in response to the threat. I lumped these under the =
> term coping but it's probably better to keep the headings from the =
> article for accuracy.</FONT></DIV></DIV>=0A=
> <P><FONT face=3DArial size=3D2>We also use Craig's PIC model, but have =
> found that the different definitions need some reinforcing. When =
> people are accustomed to working with RCTs and the traditional PICO, =
> they tend to confuse Interventions with Interest until they have had =
> some practice. </FONT></P>=0A=
> <P><FONT face=3DArial size=3D2>Craig, where do you place the FIndings in =
> your acronym?</FONT></P>=0A=
> <DIV><FONT face=3DArial size=3D2>Carlos asked '</FONT>wouldn't be better =
> to consider the question into the frame of background vs foreground =
> questions? If so, this would obviously be a background =
> question.'<BR></DIV>=0A=
> <DIV><SPAN lang=3DEN-US style=3D"FONT-SIZE: 10pt; FONT-FAMILY: Arial; =
> mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; =
> mso-fareast-language: EN-US; mso-bidi-language: AR-SA">Sackett et al =
> (2000) characterizes background questions as ‘who, what, =
> where, when, why and how’ questions. This fits =
> with qualitative questions. And qualitative research can provide =
> good background information to inform systematic reveiw protocols.The =
> Cochrane Qualitative Research Methods Group is working on this =
> now. </SPAN></DIV>=0A=
> <DIV><SPAN lang=3DEN-US style=3D"FONT-SIZE: 10pt; FONT-FAMILY: Arial; =
> mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; =
> mso-fareast-language: EN-US; mso-bidi-language: =
> AR-SA"></SPAN> </DIV>=0A=
> <DIV><SPAN lang=3DEN-US style=3D"FONT-SIZE: 10pt; FONT-FAMILY: Arial; =
> mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; =
> mso-fareast-language: EN-US; mso-bidi-language: AR-SA">Best =
> wishes</SPAN></DIV>=0A=
> <DIV><SPAN lang=3DEN-US style=3D"FONT-SIZE: 10pt; FONT-FAMILY: Arial; =
> mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; =
> mso-fareast-language: EN-US; mso-bidi-language: =
> AR-SA">Janet </SPAN><BR></DIV>=0A=
> <DIV dir=3Dltr><BR></DIV>=0A=
> <DIV dir=3Dltr>=0A=
> <HR tabIndex=3D-1>=0A=
> </DIV>=0A=
> <DIV dir=3Dltr><FONT face=3DTahoma size=3D2><B>Fra:</B> Evidence based =
> health (EBH) p=E5 vegne av Craig Lockwood<BR><B>Sendt:</B> s=F8 =
> 22.02.2009 23:33<BR><B>Til:</B> =
> [log in to unmask]<BR><B>Emne:</B> Re: SV: Qualitative =
> research and PICO<BR></FONT><BR></DIV>=0A=
> <DIV><FONT face=3D"Century Gothic"><SPAN style=3D"FONT-SIZE: 12px">Dear =
> All,<BR>I have some affinity with the PICO format, its great in that =
> existing familiarity can assist with the teaching process, and with some =
> adaptation, I use the same approach for qualitative reviews. <BR>In =
> usage, PICO becomes<BR>P <U>Population<BR></U>I =
> phenomena of <U>Interest<BR></U>Co =
> <U>Context<BR></U><BR><BR>The phenomena of interest being (in a =
> phenomenological example) the lived experience. <BR><BR>The =
> question in action might look like<BR><BR>“What is the lived =
> experience of younger, disabled people residing in long term care =
> environments for older adults?”<BR><BR>The population being =
> younger people with a disability, the phenomena of interest being =
> their experiences and the context being that they are living in an =
> environment designed for older adults not living independently. =
> <BR><BR>This is the format I use for teaching question development =
> for qualitative systematic review titles also; although I don’t =
> know of any published reviews that describe their process of question =
> development that report using this approach.<BR><BR>Kind =
> regards<BR>Craig<BR><BR><B><BR><BR>Craig Lockwood<BR></B>Associate =
> Director / Research & Innovation<BR>The Joanna Briggs =
> Institute<BR>Royal Adelaide Hospital<BR>North Terrace<BR>Adelaide, South =
> Australia 5000<BR><BR>p: +61 8 8303 4880 =
> <BR>f: +61 8 8303 8280 =
> <BR><BR><IMG src=3D"image.jpg"><BR><FONT =
> color=3D#ff0000><B><BR></B></FONT><BR><BR><BR><BR>=0A=
> <HR align=3Dcenter width=3D"95%" SIZE=3D3>=0A=
> <B>From: </B>Ornissa Naidoo =
> <[log in to unmask]><BR><B>Reply-To: </B>Ornissa =
> Naidoo <[log in to unmask]><BR><B>Date: </B>Mon, 23 =
> Feb 2009 08:16:43 +1000<BR><B>To: =
> </B>"[log in to unmask]" <mailto:[log in to unmask]> =
> <[log in to unmask]><BR><B>Subject: </B>Re: SV: =
> Qualitative research and PICO<BR><BR>Greetings<BR>Very interesting =
> debate,<BR>Yes I tend to use PICO,<BR>I agree with =
> Janet:<BR></SPAN></FONT><SPAN style=3D"FONT-SIZE: 12px"><FONT =
> face=3DArial>P: Parents<BR>I: Is not a manipulated intervention, =
> but rather an event that occurs <BR></FONT><FONT face=3D"Century =
> Gothic"><BR>Hence I would use it as follows:<BR>P- Parents of preschool =
> children who are acutely ill<BR>I- Parents beliefs/concerns<BR>C- =
> Nil<BR>O- ( Not sure what you would eventually hope to achieve with the =
> information for eg:)<BR> - Less stressed patients of acutely =
> ill preschool children ....<BR> <BR>Hope this helps<BR>Kind regards =
> <BR>Ornissa Naidoo <BR><BR><BR>>>> "k.hopayian" =
> <[log in to unmask]> 23/02/2009 7:15 am =
> >>><BR></FONT></SPAN><FONT size=3D5><FONT face=3D"Times, Times =
> New Roman"><SPAN style=3D"FONT-SIZE: 18px">Hello Janet,<BR>Thanks for =
> that. Yes, Booth and Brice�s SPICE structure does seem well =
> suited although it was developed with information =
> services/librarians� situation in mind. May I bounce back a few =
> things for you to consider?<BR>1 In teaching, it is good to have =
> consistency so before accepting a new tool, I would want to be sure that =
> the old one has more disadvantages than advantages (your ref to shoe =
> horning points to a disadvantage).<BR>2 PICO of course is not just for =
> interventions, it works with diagnostic and prognostic questions too =
> (its suitability as an acronym has been debated here before)<BR>3 I =
> think the Evaluation in SPICE as used below should actually be the =
> parents� beliefs and concerns about children becoming ill =
> � these are the results. <BR><BR>Kev<BR><BR>Dr Kev (Kevork) =
> Hopayian MD FRCGP<BR>GP Tutor<BR>Postgraduate Medical Centre<BR>Ipswich =
> Hospital<BR>Ipswich<BR>Suffolk<BR><BR>-------on 22/02/2009 17:59, Janet =
> Harris at [log in to unmask] <about:[log in to unmask]> <about:[log in to unmask]>> ; =
> wrote:<BR><BR></SPAN></FONT></FONT>=0A=
> <BLOCKQUOTE><FONT size=3D5><SPAN style=3D"FONT-SIZE: 18px"><FONT =
> face=3DArial>Hi Kev<BR></FONT></SPAN></FONT><FONT size=3D4><FONT =
> face=3D"Verdana, Helvetica, Arial"><SPAN style=3D"FONT-SIZE: =
> 13px"><BR></SPAN></FONT><SPAN style=3D"FONT-SIZE: 13px"><FONT =
> face=3DArial>PICO is good when you want to compare interventions and =
> outcomes but it's difficult to shoehorn qulaitative questions into this =
> format.. Qualitative questions explore perceptions of health issues, =
> attitudes toward interventions, experiences with interventions, and =
> acceptability of outcomes. They may compare diverse views and =
> experiences across different people but the comparison isn't manipulated =
> by putting people into different groups. <BR></FONT><FONT =
> face=3D"Verdana, Helvetica, Arial"><BR></FONT><FONT face=3DArial>An =
> alternative format suggested b Booth & Brice (2003) is =
> </FONT></SPAN></FONT><FONT size=3D5><FONT face=3D"Times, Times New =
> Roman"><SPAN style=3D"FONT-SIZE: 18px">SPICE <BR>Setting: of the =
> research<BR>Perspective: of those who are experiencing the intervention =
> or the situation of interest<BR>Intervention/Phenomena of Interest: the =
> intervention or the phenomenon that is being experienced<BR>Comparison: =
> may be with those who do not receive the intervention or experience the =
> phenomenon<BR>Evaluation. What is being explored or evaluated in the =
> study<BR></SPAN></FONT></FONT><FONT size=3D4><FONT face=3D"Verdana, =
> Helvetica, Arial"><SPAN style=3D"FONT-SIZE: =
> 13px"><BR></SPAN></FONT></FONT><FONT size=3D5><FONT face=3D"Times, Times =
> New Roman"><SPAN style=3D"FONT-SIZE: 18px">Going back to your article, =
> it could be formatted like this: <BR></SPAN></FONT></FONT><FONT =
> size=3D4><FONT face=3DArial><SPAN style=3D"FONT-SIZE: 13px"><BR><BR>S: =
> Disadvantaged inner city community<BR>P: Parents <BR>I: =
> Acutely ill preschool children <BR>C: None<BR>E: .Coping =
> when young children become acutely ill<BR> <BR>All elements are not =
> always present - it depends on the question. =
> <BR> <BR>You could alternatively formulate it as a PO, =
> PI or PIO keeping in mind that your definitions for PIO are a bit =
> different e.g.<BR>P: Parents<BR>I: Is not a manipulated =
> intervention, but rather an event that occurs - acute illness in =
> preschool children<BR> <BR>Hope that helps.<BR> <BR>Best =
> wishes<BR>Janet<BR> <BR>Janet Harris<BR>Associate =
> Professor<BR>University College Bergen<BR>Centre for Evidence Based =
> Practice<BR>M�llandahlsveien 6<BR>Bergen =
> 5009<BR>Norway<BR> &=
> nbsp; <BR></SPAN></FONT><SPAN =
> style=3D"FONT-SIZE: 13px"><FONT face=3D"Verdana, Helvetica, Arial"><BR>=0A=
> <HR align=3Dcenter width=3D"100%" SIZE=3D3>=0A=
> </FONT></SPAN></FONT><FONT size=3D5><FONT face=3DTahoma><SPAN =
> style=3D"FONT-SIZE: 18px"><B>Fra:</B></SPAN></FONT></FONT><FONT =
> face=3DTahoma><FONT size=3D4><SPAN style=3D"FONT-SIZE: 13px"> Evidence =
> based health (EBH) p� vegne av Padmanabhan =
> badrinath<BR><B>Sendt:</B> s� 22.02.2009 16:17<BR><B>Til:</B> =
> [log in to unmask] =
> <about:[log in to unmask]> <about:[log in to unmask]>> ; <BR><B>Emne:</B> =
> Qualitative research and PICO or PECOT & CASP =
> checklists<BR></SPAN></FONT></FONT><FONT size=3D4><SPAN =
> style=3D"FONT-SIZE: 13px"><FONT face=3D"Verdana, Helvetica, =
> Arial"><BR></FONT><FONT face=3DArial>Dear Kev,<BR></FONT><FONT =
> face=3D"Verdana, Helvetica, Arial"><BR></FONT><FONT face=3DArial>A very =
> good afternoon and early spring greetings from the East of =
> Englnd.<BR></FONT><FONT face=3D"Verdana, Helvetica, =
> Arial"><BR></FONT><FONT face=3DArial>A quick look at the CASP worksheets =
> for the RCT and qualitative desingns shows that first question is very =
> different. <BR>CASP checklist for RCT available at<BR><A =
> href=3D"http://www.phru.nhs.uk/Doc_Links/rct" <http://www.phru.nhs.uk/Doc_Links/rct> >http://www.phru.nhs.uk/Doc_=
> Links/rct</A> appraisal tool.pdf <BR></FONT><FONT face=3D"Verdana, =
> Helvetica, Arial"><BR></FONT><FONT face=3DArial>The first question is: =
> <BR></FONT><FONT face=3D"Verdana, Helvetica, Arial"><BR></FONT><FONT =
> face=3DArial>Did the study ask a clearly-focused question? =
> <BR></FONT><FONT face=3D"Verdana, Helvetica, Arial"><BR></FONT><FONT =
> face=3DArial><I>Consider if the question is �focused� in =
> terms of: <BR>� the population studied <BR>� the =
> intervention given <BR>� the outcomes =
> considered<BR></I></FONT><FONT face=3D"Verdana, Helvetica, =
> Arial"><BR></FONT><FONT face=3DArial>CASP checklist for qualitative =
> study available at <BR><A =
> href=3D"http://www.phru.nhs.uk/Doc_Links/Qualitative" <http://www.phru.nhs.uk/Doc_Links/Qualitative> >http://www.phru.nhs=
> .uk/Doc_Links/Qualitative</A> Appraisal Tool.pdf <BR></FONT><FONT =
> face=3D"Verdana, Helvetica, Arial"><BR></FONT><FONT face=3DArial>The =
> first question is:<BR></FONT><FONT face=3D"Verdana, Helvetica, =
> Arial"><BR></FONT><FONT face=3DArial>Was there a clear statement of the =
> aims of the research? <BR></FONT><FONT face=3D"Verdana, Helvetica, =
> Arial"><BR></FONT><FONT face=3DArial><I>Consider: <BR>� what the =
> goal of the research was <BR>� why it is important <BR>� =
> its relevance<BR></I></FONT><FONT face=3D"Verdana, Helvetica, =
> Arial"><BR></FONT><FONT face=3DArial>It appears that the PICO format is =
> more suited for therapy questions. <BR></FONT><FONT face=3D"Verdana, =
> Helvetica, Arial"><BR></FONT><FONT face=3DArial>You might also find this =
> paper by Huang et al of interest. <BR></FONT><FONT face=3D"Verdana, =
> Helvetica, Arial"><BR></FONT><FONT face=3DArial>Evaluation of PICO as a =
> Knowledge Representation for Clinical Questions<BR><A =
> href=3D"http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3D18397=
> 40" <http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3D18397=40> >http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3D1839740</=
> A> <BR></FONT><FONT face=3D"Verdana, Helvetica, Arial"><BR></FONT><FONT =
> face=3DArial>"Our study shows that the PICO framework is best suited for =
> representing therapy questions, and considerably less-suited for =
> diagnosis, etiology, and prognosis questions. In some cases, it is =
> difficult to encode certain question classes without modifying the =
> existing PICO structure or introducing counterintuitive elements. Given =
> that the PICO framework is a well-established tool for formulating =
> clinical queries, any limitations of the framework itself could =
> potentially impact the quality of clinical evidence retrieved under its =
> guidance. This study reveals a number of challenges associated with PICO =
> analysis, which will serve as a basis for refining the principles of =
> clinical query formulation".<BR></FONT><FONT face=3D"Verdana, Helvetica, =
> Arial"><BR></FONT><FONT face=3DArial>Warm regards & very best =
> wishes,<BR></FONT><FONT face=3D"Verdana, Helvetica, =
> Arial"><BR></FONT><FONT face=3DArial>Badri<BR></FONT><FONT =
> face=3D"Verdana, Helvetica, Arial"><BR>Dr P Badrinath MD BS M.Phil MPH =
> FFPH PhD (Cantab) Consultant in Public Health Medicine & Affiliated =
> Clinical Lecturer Suffolk PCT & University of Cambridge Rushbrook =
> house, Paper mill lane, Bramford, Ipswich, IP8 4DE, Suffolk, UK <A =
> href=3D"http://myprofile.cos.com/badrishanthi" <http://myprofile.cos.com/badrishanthi> >http://myprofile.cos.com/b=
> adrishanthi</A> <BR><BR><BR> <BR>> Date: Sun, 22 Feb 2009 =
> 10:08:25 +0000<BR>> From: [log in to unmask] =
> <about:[log in to unmask]> <about:[log in to unmask]>> ; <BR>> Subject: =
> Qualitative research and PICO or PECOT<BR>> To: =
> [log in to unmask] =
> <about:[log in to unmask]> <about:[log in to unmask]>> ; <BR>> =
> <BR>> Does anyone have experience of setting the research question in =
> a<BR>> qualitative study into the PIO or PICO or PECOT format? It =
> seems possible to<BR>> do so but I have not seen it done.<BR>> P =
> is easy to identify but the E or I and O less so. There is sometimes a =
> C<BR>> but more often not.<BR>> For example, in a study "To =
> identify and explore parents' concerns when<BR>> preschool children =
> become acutely ill."<BR>> <A =
> href=3D"http://www.bmj.com/cgi/content/full/313/7063/983" <http://www.bmj.com/cgi/content/full/313/7063/983> >http://www.bmj.=
> com/cgi/content/full/313/7063/983</A><BR>> P =3D parents' of =
> preschool children<BR>> E or I =3D children develop an acute illness =
> (note - this does not imply the<BR>> children have acute illness =
> during the study, rather the parents consider<BR>> their =
> experience)<BR>> O =3D their beliefs and concerns.<BR>> So it can =
> be done but my questions to the group are:<BR>> 1 Any views on using =
> PIO/PICO in this situation? Does it add anything of<BR>> value to our =
> appreciation of the paper over and above a narrative expression<BR>> =
> of the research question (as in the title above)?<BR>> 2 Do you have =
> experience of doing so? Could you tell us more?<BR>> -- <BR>> B/W, =
> Kev Hopayian<BR><BR></FONT></SPAN></FONT></BLOCKQUOTE><FONT =
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>
> ------_=_NextPart_001_01C99593.E6111D7A--
>
> ------------------------------
>
> Date: Mon, 23 Feb 2009 13:01:28 -0500
> From: Jim Walker <[log in to unmask]> <mailto:[log in to unmask]>
> Subject: Re: Basic question about diagnostic versus prognostic studies
>
> One dimension of difference is clinician intent:
> A diagnostic test is ordered to establish the probabilities of a group of=
> candidate physiologic processes.
> A prognostic test is ordered to establish the probabilities of candidate =
> courses of the disease process.
>
> Many tests satisfy both intentions and may be ordered with either single =
> intention or combining the two.
>
> Jim
>
> James M. Walker, MD, FACP
> Chief Health Information Officer
> Geisinger Health System
> =20
> =20
> If the human mind was simple enough to understand, we'd be too simple to =
> understand it.
> - Emerson Pugh=20
>
>
>
>
>
>
>
> Steve Simon <[log in to unmask]> <mailto:[log in to unmask]> 2/20/2009 2:21 PM >>>
>
>
>
>
>
> Maybe this is a stupid question, but here goes.
>
> What is the difference between a diagnostic study and a prognostic=20
> study? Is it that diagnostic study examines one of more factors that can=20
> help identify an already existing condition whereas a prognostic study=20
> examines one of more factors that can predict a future condition? Is it=20
> that diagnosis is targeted towards something bad (disease) while=20
> prognosis is targeted towards something good (recovery)? Or is it=20
> something else?
> --=20
> Steve Simon, Standard Disclaimer.
> Sign up for my brand new newsletter,
> The Monthly Mean, at www.pmean.com/news <http://www.pmean.com/news>
>
>
>
> IMPORTANT WARNING: The information in this message (and the documents att=
> ached to it, if any) is confidential and may be legally privileged. It is=
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> ou.
>
> ------------------------------
>
> End of EVIDENCE-BASED-HEALTH Digest - 22 Feb 2009 to 23 Feb 2009 (#2009-45)
> ***************************************************************************
>
>
>
> Dr Martin Dawes
> Chair Family Medicine
> McGill University
> 515 Pine Avenue West, Montreal
> Quebec, Canada
> Tel 514 398 7375 x0469
> Fax 514 398 4202
>
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