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
Content-Type: text/plain; charset=ISO-8859-1
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
Content-Type: text/html; charset=ISO-8859-1
Content-Transfer-Encoding: quoted-printable
<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.
------_=_NextPart_001_01C99593.E6111D7A
Content-Type: multipart/alternative;
boundary="----_=_NextPart_002_01C99593.E6111D7A"
------_=_NextPart_002_01C99593.E6111D7A
Content-Type: text/plain;
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
*************************************************************************=
*******
This email, including any attachments sent with it, is confidential and =
for the sole use of the intended recipient(s). This confidentiality is =
not waived or lost, if you receive it and you are not the intended =
recipient(s), or if it is transmitted/received in error.
Any unauthorised use, alteration, disclosure, distribution or review of =
this email is strictly prohibited. The information contained in this =
email, including any attachment sent with it, may be subject to a =
statutory duty of confidentiality if it relates to health service =
matters.
If you are not the intended recipient(s), or if you have received this =
email in error, you are asked to immediately notify the sender by =
telephone collect on Australia +61 1800 198 175 or by return email. You =
should also delete this email, and any copies, from your computer system =
network and destroy any hard copies produced.
If not an intended recipient of this email, you must not copy, =
distribute or take any action(s) that relies on it; any form of =
disclosure, modification, distribution and/or publication of this email =
is also prohibited.
Although Queensland Health takes all reasonable steps to ensure this =
email does not contain malicious software, Queensland Health does not =
accept responsibility for the consequences if any person's computer =
inadvertently suffers any disruption to services, loss of information, =
harm or is infected with a virus, other malicious computer programme or =
code that may occur as a consequence of receiving this email.
Unless stated otherwise, this email represents only the views of the =
sender and not the views of the Queensland Government.
*************************************************************************=
*********
------_=_NextPart_002_01C99593.E6111D7A
Content-Type: text/html;
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=
<META content=3D"MSHTML 6.00.2900.3492" name=3DGENERATOR></HEAD>=0A=
<BODY>=0A=
<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 =
size=3D4><SPAN style=3D"FONT-SIZE: 13px"><FONT face=3D"Verdana, =
Helvetica, Arial"><BR></FONT></SPAN></FONT><FONT size=3D5><FONT =
face=3D"Times, Times New Roman"><SPAN style=3D"FONT-SIZE: =
18px"><BR><BR>-- <BR><BR></SPAN></FONT></FONT><FONT face=3D"Century =
Gothic"><SPAN style=3D"FONT-SIZE: 12px"><BR></SPAN><FONT size=3D2><SPAN =
style=3D"FONT-SIZE: =
10px">*******************************************************************=
*************<BR></SPAN></FONT><SPAN style=3D"FONT-SIZE: =
12px"><BR></SPAN><FONT size=3D2><SPAN style=3D"FONT-SIZE: 10px">This =
email, including any attachments sent with it, is confidential and for =
the sole use of the intended recipient(s). This confidentiality is not =
waived or lost, if you receive it and you are not the intended =
recipient(s), or if it is transmitted/received in =
error.<BR></SPAN></FONT><SPAN style=3D"FONT-SIZE: 12px"><BR></SPAN><FONT =
size=3D2><SPAN style=3D"FONT-SIZE: 10px">Any unauthorised use, =
alteration, disclosure, distribution or review of this email is strictly =
prohibited. The information contained in this email, including any =
attachment sent with it, may be subject to a statutory duty of =
confidentiality if it relates to health service =
matters.<BR></SPAN></FONT><SPAN style=3D"FONT-SIZE: =
12px"><BR></SPAN><FONT size=3D2><SPAN style=3D"FONT-SIZE: 10px">If you =
are not the intended recipient(s), or if you have received this email in =
error, you are asked to immediately notify the sender by telephone =
collect on Australia +61 1800 198 175 or by return email. You =
should also delete this email, and any copies, from your computer system =
network and destroy any hard copies produced.<BR></SPAN></FONT><SPAN =
style=3D"FONT-SIZE: 12px"><BR></SPAN><FONT size=3D2><SPAN =
style=3D"FONT-SIZE: 10px">If not an intended recipient of this email, =
you must not copy, distribute or take any action(s) that relies on it; =
any form of disclosure, modification, distribution and/or publication of =
this email is also prohibited.<BR></SPAN></FONT><SPAN =
style=3D"FONT-SIZE: 12px"><BR></SPAN><FONT size=3D2><SPAN =
style=3D"FONT-SIZE: 10px">Although Queensland Health takes all =
reasonable steps to ensure this email does not contain malicious =
software, Queensland Health does not accept responsibility for the =
consequences if any person's computer inadvertently suffers any =
disruption to services, loss of information, harm or is infected with a =
virus, other malicious computer programme or code that may occur as a =
consequence of receiving this email.<BR></SPAN></FONT><SPAN =
style=3D"FONT-SIZE: 12px"><BR></SPAN><FONT size=3D2><SPAN =
style=3D"FONT-SIZE: 10px">Unless stated otherwise, this email represents =
only the views of the sender and not the views of the Queensland =
Government.<BR></SPAN></FONT><SPAN style=3D"FONT-SIZE: =
12px"><BR></SPAN><FONT size=3D2><SPAN style=3D"FONT-SIZE: =
10px">*******************************************************************=
***************<BR></SPAN></FONT><SPAN style=3D"FONT-SIZE: =
12px"><BR></SPAN><FONT size=3D2><SPAN style=3D"FONT-SIZE: =
10px"><BR></SPAN></FONT><SPAN style=3D"FONT-SIZE: =
12px"><BR></SPAN></FONT></DIV></BODY></HTML>
------_=_NextPart_002_01C99593.E6111D7A--
------_=_NextPart_001_01C99593.E6111D7A
Content-Type: image/jpeg;
name="image.jpg"
Content-Transfer-Encoding: base64
Content-ID: <3318224632_43569>
Content-Description: image.jpg
Content-Location: image.jpg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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=
intended solely for the addressee. Access to this message by anyone else=
is unauthorized. If you are not the intended recipient, any disclosure, =
copying, distribution or any action taken, or omitted to be taken, in rel=
iance on it is prohibited and may be unlawful. If you have received this =
message in error, please delete all electronic copies of this message (an=
d the documents attached to it, if any), destroy any hard copies you may =
have created and notify me immediately by replying to this email. Thank y=
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
|
