Hi Kev
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.
An alternative format suggested b Booth & Brice (2003) is SPICE
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
Going back to your article, it could be formatted like this:
S: Disadvantaged inner city community
P: Parents
I: Acutely ill preschool children
C: None
E: .Coping when young children become acutely ill
All elements are not always present - it depends on the question.
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
Hope that helps.
Best wishes
Janet
Janet Harris
Associate Professor
University College Bergen
Centre for Evidence Based Practice
Møllandahlsveien 6
Bergen 5009
Norway
________________________________
Fra: Evidence based health (EBH) på vegne av Padmanabhan badrinath
Sendt: sø 22.02.2009 16:17
Til: [log in to unmask]
Emne: Qualitative research and PICO or PECOT & CASP checklists
Dear Kev,
A very good afternoon and early spring greetings from the East of Englnd.
A quick look at the CASP worksheets for the RCT and qualitative desingns shows that first question is very different.
CASP checklist for RCT available at
http://www.phru.nhs.uk/Doc_Links/rct%20appraisal%20tool.pdf
The first question is:
Did the study ask a clearly-focused question?
Consider if the question is 'focused' in terms of:
- the population studied
- the intervention given
- the outcomes considered
CASP checklist for qualitative study available at
http://www.phru.nhs.uk/Doc_Links/Qualitative%20Appraisal%20Tool.pdf
The first question is:
Was there a clear statement of the aims of the research?
Consider:
- what the goal of the research was
- why it is important
- its relevance
It appears that the PICO format is more suited for therapy questions.
You might also find this paper by Huang et al of interest.
Evaluation of PICO as a Knowledge Representation for Clinical Questions
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1839740
"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".
Warm regards & very best wishes,
Badri
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
> Date: Sun, 22 Feb 2009 10:08:25 +0000
> From: [log in to unmask]
> Subject: Qualitative research and PICO or PECOT
> To: [log in to unmask]
>
> 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 = parents' of preschool children
> E or I = 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 = 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?
> --
> B/W, Kev Hopayian
