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Palaskar, JayantN. "Framing the research question using PICO strategy." Journal of Dental and Allied Sciences 6, no. 2 (2017): 55. http://dx.doi.org/10.4103/jdas.jdas_46_17.
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Nishikawa-Pacher, Andreas. "Research Questions with PICO: A Universal Mnemonic." Publications 10, no. 3 (June 22, 2022): 21. http://dx.doi.org/10.3390/publications10030021.
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A well-formulated research question should incorporate the components of a ‘problem’, an ‘intervention’, a ‘control’, and an ‘outcome’—at least according to the PICO mnemonic. The utility of this format, however, has been said to be limited to clinical studies that pose ‘which’ questions demanding correlational study designs. In contrast, its suitability for descriptive approaches outside of clinical investigations has been doubted. This paper disagrees with the alleged limitations of PICO. Instead, it argues that the scheme can be used universally for every scientific endeavour in any discipline with all study designs. This argument draws from four abstract components common to every research, namely, a research object, a theory/method, a (null) hypothesis, and the goal of knowledge generation. Various examples of how highly heterogenous studies from different disciplines can be grounded in the single scheme of PICO are offered. The finding implies that PICO is indeed a universal technique that can be used for teaching academic writing in any discipline, beyond clinical settings, regardless of a preferred study design.
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Stone, Patricia W. "Popping the (PICO) question in research and evidence-based practice." Applied Nursing Research 15, no. 3 (August 2002): 197–98. http://dx.doi.org/10.1053/apnr.2002.34181.
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Koterski, Joseph W. "Circe’s Beasts and the Image of God: More’s Creative Appropriation of Pico’s Humanist Spirituality." Moreana 47 (Number 179-, no. 1-2 (June 2010): 45–62. http://dx.doi.org/10.3366/more.2010.47.1-2.5.
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In More’s preface to the first of the letters of Pico that he translated for inclusion in his Life of Pico, he explains Pico’s account of the beasts into which Circe changes various men. To what he finds in Pico, More adds his own comments about possible deformations of the image of God within us. This paper reviews relevant portions of More’s Life of Pico and of Pico’s letters in light of the general question of Pico’s grounds for the dignity of human nature and argues that More has provided a kind of friendly amendment to the views of Pico on the ultimate grounds for human dignity, not only in the preface to the letters but also in his way of handling Pico’s three sets of rules for spiritual warfare.
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Santos, Cristina Mamédio da Costa, Cibele Andrucioli de Mattos Pimenta, and Moacyr Roberto Cuce Nobre. "The PICO strategy for the research question construction and evidence search." Revista Latino-Americana de Enfermagem 15, no. 3 (June 2007): 508–11. http://dx.doi.org/10.1590/s0104-11692007000300023.
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Evidence based practice is the use of the best scientific evidence to support the clinical decision making. The identification of the best evidence requires the construction of an appropriate research question and review of the literature. This article describes the use of the PICO strategy for the construction of the research question and bibliographical search.
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Vong, Wan-Tze, and Patrick Hang Hui Then. "Known-Item Retrieval Performance of a PICO-based Medical Question Answering Engine." Asia Pacific Journal of Information Systems 25, no. 4 (December 30, 2015): 686–711. http://dx.doi.org/10.14329/apjis.2015.25.4.686.
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Jin, Di, and Peter Szolovits. "Advancing PICO element detection in biomedical text via deep neural networks." Bioinformatics 36, no. 12 (April 20, 2020): 3856–62. http://dx.doi.org/10.1093/bioinformatics/btaa256.
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Abstract Motivation In evidence-based medicine, defining a clinical question in terms of the specific patient problem aids the physicians to efficiently identify appropriate resources and search for the best available evidence for medical treatment. In order to formulate a well-defined, focused clinical question, a framework called PICO is widely used, which identifies the sentences in a given medical text that belong to the four components typically reported in clinical trials: Participants/Problem (P), Intervention (I), Comparison (C) and Outcome (O). In this work, we propose a novel deep learning model for recognizing PICO elements in biomedical abstracts. Based on the previous state-of-the-art bidirectional long-short-term memory (bi-LSTM) plus conditional random field architecture, we add another layer of bi-LSTM upon the sentence representation vectors so that the contextual information from surrounding sentences can be gathered to help infer the interpretation of the current one. In addition, we propose two methods to further generalize and improve the model: adversarial training and unsupervised pre-training over large corpora. Results We tested our proposed approach over two benchmark datasets. One is the PubMed-PICO dataset, where our best results outperform the previous best by 5.5%, 7.9% and 5.8% for P, I and O elements in terms of F1 score, respectively. And for the other dataset named NICTA-PIBOSO, the improvements for P/I/O elements are 3.9%, 15.6% and 1.3% in F1 score, respectively. Overall, our proposed deep learning model can obtain unprecedented PICO element detection accuracy while avoiding the need for any manual feature selection. Availability and implementation Code is available at https://github.com/jind11/Deep-PICO-Detection.
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Korenoski, Amanda, Angela Li, Sandra L. Kane-Gill, Amy L. Seybert, and Pamela L. Smithburger. "Pharmacologic Management of Delirium in the ICU: A Review of the Literature." Journal of Intensive Care Medicine 35, no. 2 (October 11, 2018): 107–17. http://dx.doi.org/10.1177/0885066618805965.
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Purpose: Conflicting data exists on the pharmacologic management of intensive care unit (ICU) delirium. This review appraises the current evidence of pharmacologic management of ICU delirium. Materials and Methods: A systematic literature search of MEDLINE and Embase was conducted to answer the population, intervention, comparison, and outcome (PICO) question of: “Does the use of a pharmacologic agent compared to standard of care or placebo improve ICU delirium in a critically ill patient population?” Results: After application of the PICO question and the inclusion and exclusion criteria, 13 articles were included. Of these articles, 7 were prospective randomized controlled trials, 1 was a prospective nonrandomized controlled trial, and 5 were retrospective investigations. The included articles differed in the agents evaluated, primary outcome, and method of identifying delirium. Conclusion: The variability of outcomes illustrates the need for a large-scale investigation to further evaluate the role of pharmacologic management of ICU delirium.
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Martínez Díaz, Juan Daniel, Verónica Ortega Chacón, and Francisco José Muñoz Ronda. "El diseño de preguntas clínicas en la práctica basada en la evidencia. Modelos de formulación." Enfermería Global 15, no. 3 (June 30, 2016): 431. http://dx.doi.org/10.6018/eglobal.15.3.239221.
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Objetivo: Identificar estructuras estandarizadas para la formulación de preguntas clínicas en el marco de la práctica basada en la evidencia. <br /><br />Método: Se realizó una revisión de la literatura. La búsqueda bibliográfica se efectuó en las bases de datos MEDLINE, CINAHL, EMBASE y LILACS, y en el buscador académico Google Scholar. Se efectuaron estrategias de búsqueda sensibles y acordes a cada base de datos. Límites de búsqueda: intervalo de tiempo (enero de 1995 a abril de 2015), idioma (artículos en inglés). Se usaron palabras clave libres y descriptores del Medical Subject Headings (MeSH) pertinentes: evidence based practice, question, formulation, well-built question, framework. <br /><br />Resultados: Se encontraron 10 manuscritos que aportaron el diseño original de estructuras para la formulación de preguntas clínicas en el ámbito de la práctica basada en la evidencia. El modelo PICO es la estructura más conocida y comúnmente utilizada en investigación cuantitativa y de él derivan los modelos PICOT, PICOTT, PICOS, PIPOH, PECORD, PESICO. En el campo de la gestión sanitaria la estructura ECLIPSE se erige para formulación de preguntas relacionadas con la gestión. Por último, para la búsqueda de evidencias cualitativas se han configurado los modelos SPICE y SPIDER adecuando sus componentes al fenómeno cualitativo. <br /><br />Conclusiones: Estos modelos estandarizadas se comportan como un instrumento idóneo para guiar la estrategia de búsqueda y delimitar el área de interés. Dada la gran variedad de piezas que integran las estructuras, su conocimiento exhaustivo acrecienta sus usos potenciales. Estas estructuras no deben ser consideradas como una guía rígida a la que ceñirse ineludiblemente.<br /><br />
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Torrejon-Moya, Aina, Keila Izquierdo-Gómez, Mario Pérez-Sayáns, Enric Jané-Salas, Antonio Marí Roig, and José López-López. "Patients with Thyroid Disorder, a Contraindication for Dental Implants? A Systematic Review." Journal of Clinical Medicine 11, no. 9 (April 25, 2022): 2399. http://dx.doi.org/10.3390/jcm11092399.
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The thyroid gland is composed of the thyroid follicles, considered to be the functional units of the thyroid gland. The synthesis of the thyroid hormones occurs in these follicles. Triiodothyronine (T3) and thyroxine (T4) are the thyroid hormones and affect metabolic processes all through the body. This systematic evaluation was performed to answer the following PICO question: “Can patients with thyroid disorders undergo dental implant rehabilitation with the same survival rate as patients without thyroid disorders?”. A systematic review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements to gather available and current evidence of thyroid disorders and its relationship with dental implants. The electronic search, in the PubMed and Cochrane databases, yielded 22 articles. Out of the 22 articles, only 11 fulfilled the inclusion criteria. Manual research of the reference list yielded no additional papers. According to the SORT criteria and answering our PICO question, level B can be established to conclude that patients with thyroid disorders can be rehabilitated with dental implants, with similar survival rates as patients without thyroid disorders. Papers with higher scientific evidence and bigger sample size should be carried out.
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Torrejon-Moya, Aina, Keila Izquierdo-Gómez, Mario Pérez-Sayáns, Enric Jané-Salas, Antonio Marí Roig, and José López-López. "Patients with Thyroid Disorder, a Contraindication for Dental Implants? A Systematic Review." Journal of Clinical Medicine 11, no. 9 (April 25, 2022): 2399. http://dx.doi.org/10.3390/jcm11092399.
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The thyroid gland is composed of the thyroid follicles, considered to be the functional units of the thyroid gland. The synthesis of the thyroid hormones occurs in these follicles. Triiodothyronine (T3) and thyroxine (T4) are the thyroid hormones and affect metabolic processes all through the body. This systematic evaluation was performed to answer the following PICO question: “Can patients with thyroid disorders undergo dental implant rehabilitation with the same survival rate as patients without thyroid disorders?”. A systematic review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements to gather available and current evidence of thyroid disorders and its relationship with dental implants. The electronic search, in the PubMed and Cochrane databases, yielded 22 articles. Out of the 22 articles, only 11 fulfilled the inclusion criteria. Manual research of the reference list yielded no additional papers. According to the SORT criteria and answering our PICO question, level B can be established to conclude that patients with thyroid disorders can be rehabilitated with dental implants, with similar survival rates as patients without thyroid disorders. Papers with higher scientific evidence and bigger sample size should be carried out.
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Silva Filho, Luiz Vicente Ribeiro Ferreira da, Flavia de Aguiar Ferreira, Francisco Jose Caldeira Reis, Murilo Carlos Amorim de Britto, Carlos Emilio Levy, Otavio Clark, and Jose Dirceu Ribeiro. "Pseudomonas aeruginosa infection in patients with cystic fibrosis: scientific evidence regarding clinical impact, diagnosis, and treatment." Jornal Brasileiro de Pneumologia 39, no. 4 (June 2013): 495–512. http://dx.doi.org/10.1590/s1806-37132013000400015.
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Evidence-based techniques have been increasingly used in the creation of clinical guidelines and the development of recommendations for medical practice. The use of levels of evidence allows the reader to identify the quality of scientific information that supports the recommendations made by experts. The objective of this review was to address current concepts related to the clinical impact, diagnosis, and treatment of Pseudomonas aeruginosa infections in patients with cystic fibrosis. For the preparation of this review, the authors defined a group of questions that would be answered in accordance with the principles of PICO–an acronym based on questions regarding the Patients of interest, Intervention being studied, Comparison of the intervention, and Outcome of interest. For each question, a structured review of the literature was performed using the Medline database in order to identify the studies with the methodological design most appropriate to answering the question. The questions were designed so that each of the authors could write a response. A first draft was prepared and discussed by the group. Recommendations were then made on the basis of the level of scientific evidence, in accordance with the classification system devised by the Oxford Centre for Evidence-Based Medicine, as well as the level of agreement among the members of the group.
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Márquez-Arrico, Cecilia Fabiana, Javier Silvestre-Rangil, Laura Gutiérrez-Castillo, Mayte Martinez-Herrera, Francisco Javier Silvestre, and Milagros Rocha. "Association between Periodontal Diseases and Polycystic Ovary Syndrome: A Systematic Review." Journal of Clinical Medicine 9, no. 5 (May 23, 2020): 1586. http://dx.doi.org/10.3390/jcm9051586.
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Background: A convergent association between polycystic ovary syndrome (PCOS) and periodontal disease, in particular chronic periodontitis (CP), has recently been proposed. The underlying molecular mechanisms of this association are not fully understood, though it is thought that chronic inflammation is responsible. Therefore, the aim of this study was to evaluate the association between periodontal disease—gingivitis and CP—and PCOS. Materials and Methods: The PICO (Participants, Intervention, Control, and Outcomes) question was as follows: “Is there an association between PCOS and CP?” A systematic review of three databases—PubMed, Embase and Scopus—was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Original studies in human cohorts carried out in the last 10 years and including a control group were eligible for inclusion. Letters to the editor, case reports, and reviews were not considered. Results: Ten articles met all the selection criteria and provided a positive answer to the PICO question. Our review of these articles revealed an association between CP and PCOS, since periodontal parameters were altered more frequently in patients with these conditions than in healthy young women. This altered periodontal response in PCOS was associated with a proinflammatory status that seemed to increase susceptibility to periodontal disease. Conclusion: Patients with PCOS appear to be more susceptible to developing periodontal diseases than women without the pathology.
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Bore, Isabelle. "Thomas More et Pic de la Mirandole: Parcours croisés." Moreana 40 (Number 153-, no. 1-2 (March 2003): 7–26. http://dx.doi.org/10.3366/more.2003.40.1-2.4.
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Partant de la constatation que le parcours de Thomas More est, en de nombreux points, semblable à celui de Pic de la Mirandole, je cherche à determiner en quoi Pic a pu être un modèle pour More. Une brève analyse de The Life of Pico me permet en particulier de poser la question de la fidélité de More par rapport à son modèle et d’évaluer l’influence de Pic sur la carrière littéraire de More tout en montrant l’ambiguïté de leurs relations.
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Stark, Barbara L., Lynette Heller, Michael D. Glascock, J. Michael Elam, and Hector Neff. "Obsidian-Artifact Source Analysis for the Mixtequilla Region, South-Central Veracruz, Mexico." Latin American Antiquity 3, no. 3 (September 1992): 221–39. http://dx.doi.org/10.2307/971716.
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Neutron activation and statistical analyses establish source ascriptions for 201 obsidian artifacts representing Preclassic, Classic, and Postclassic period contexts in the Gulf Coast region of Mexico. Zaragoza-Oyameles, Puebla, and Pico de Orizaba, Veracruz, are the most common sources, but procurement patterns and technology shifted during the archaeological sequence. Comparative information is discussed for all periods, but especially the distribution of Zaragoza-Oyameles obsidian in the Classic period is examined. The distribution network for this obsidian served several regions. The importance of long-distance obsidian distribution for Teotihuacán is called into question.
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Thornton, Brian H., and David B. Bogy. "A Numerical Study of Air-Bearing Slider Form-Factors." Journal of Tribology 126, no. 3 (June 28, 2004): 553–58. http://dx.doi.org/10.1115/1.1691435.
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This paper presents a numerical study comparing the performance of air bearing slider form-factors. The air bearing slider and air bearing surface (ABS) design has gone through drastic changes in recent years in order to achieve the performance required by lower flying heights. In the past, improvements have been seen by scaling down the form-factors of air bearing sliders. The pico form-factor 1.25×1mm has been successfully used for several generations of products and the question arises—should the form-factor be scaled down further? The dynamic characteristics and flying-height modulation (FHM) performance of two different ABS designs in the pico and femto 0.82×0.66mm form-factors were numerically investigated. It was found that for the smaller form-factor designs, greater damping of the air bearing film and slider body system was achieved but with an undesirable decrease in modal frequencies. However, depending on the ABS design, beneficial dynamic properties can be achieved by scaling down the form-factor from pico to femto. Maximizing the total air bearing force (the sum of negative and positive) with a design featuring a large number of transverse pressure gradients can obtain high stiffness and damping. Geometric FHM was also investigated using both sinusoidal disk waviness and an actual measured disk topography. It was found that the FHM depends not only on the form-factor, but also on the ABS design. For long disk waviness wavelengths (longer than the slider body length, L), the FHM is proportional to Lβ where β was found to be between 2.6 and 4; hence, FHM is dependent on form-factor. For short disk waviness wavelengths, the FHM is a function of the ABS design and flying attitude and not form-factor. A disk waviness wavelength of 3 mm demarks the transition above which the FHM is a function of form-factor and below which the FHM is a function of the ABS design and the superposition of these two effects compose the geometric FHM. Simulations with an actual measured disk topography showed that the femto form-factor exhibited 22–32 percent less FHM than the pico form-factor for a similar design. However, by changing the ABS design, 35–40 percent less FHM was achieved within the same form-factor. By scaling down a pico slider to a femto slider, we do not necessarily achieve enhanced overall performance. Significant performance improvements in the pico form-factor can be attained if the ABS is properly designed. However, in designing a dynamically stable and low FHM air bearing slider a femto slider ultimately yields better performance when care is taken in designing the ABS.
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Craig Truglia. "Al-Ghazali and Giovanni Pico della Mirandola on the Question of Human Freedom and the Chain of Being." Philosophy East and West 60, no. 2 (2010): 143–66. http://dx.doi.org/10.1353/pew.0.0101.
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Lago, Josilene Nascimento do, Cosmo de Sousa Costa, Larissa Emily de Carvalho Moraes, Raissa Ribeiro da Silva, Gleiciane Moraes Gonçalves, Thainar Stefanie Barbosa de Oliveira, Tatiane Roseli Alves Castro, et al. "Meta-analysis." International Journal for Innovation Education and Research 8, no. 8 (August 6, 2020): 73–87. http://dx.doi.org/10.31686/ijier.vol8.iss8.2493.
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Objective: identify and analyse the evidences about the use of hydroxychloroquine with or without azithromycin in covid-19. Methods: This is a systematic review with meta-analysis using posted articles in December 2019 until May 2020. The research was formulated by a question structured using PICO strategy, in these data bases: BVS, PUBMED, MEDLINE, LILACS, BDENF e SCIELO. Results and discussion: Resulted in 9 articles founded by the PRISMA, approaching 4182 patients. PICO strategy selected and analysed 5 articles projected in Forest plots. Resulting in tree clinical trials (RR: 1.15; IC95%, 0.76 a 1.73), which did not found big differences in the outcome in the groups of patients who used HCQ with or without AZT, comparing with the control group. Two studies analysed the number of deaths/intubations in comparative group, experimental group and control (RR:1.86; IC: 95%, 1.54 a 2.26) resulting in more chance of death /intubation in patients who used HCQ. Conclusion: It was found that is not possible to prove the efficacy of these drugs, due to the limited number of randomized and controlled clinical trials. Therefore, the encourage of scientific production about the HCQ and AZT against Covid-19 is more than necessary.
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Berstock, James R., and Michael R. Whitehouse. "How to prepare and manage a systematic review and meta-analysis of clinical studies." EFORT Open Reviews 4, no. 5 (May 2019): 213–20. http://dx.doi.org/10.1302/2058-5241.4.180049.
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Use the PICO framework to formulate a specific clinical question. Formulate a search strategy. Prospectively register the review protocol. Execute the literature search. Apply eligibility criteria to exclude irrelevant studies. Extract data and appraise each study for risk of bias and external validity. Provide a narrative review. If appropriate data are available, perform a meta-analysis. Report the review findings in the context of the risk of bias assessment, any sensitivity analyses and the analysis of risk of publication bias. Useful resources include the Cochrane Handbook, PROSPERO, GRADE and PRISMA. Cite this article: EFORT Open Rev 2019;4:213-220. DOI: 10.1302/2058-5241.4.180049
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Tektonidou, Maria G., Laura Andreoli, Marteen Limper, Angela Tincani, and Michael M. Ward. "Management of thrombotic and obstetric antiphospholipid syndrome: a systematic literature review informing the EULAR recommendations for the management of antiphospholipid syndrome in adults." RMD Open 5, no. 1 (April 2019): e000924. http://dx.doi.org/10.1136/rmdopen-2019-000924.
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ObjectiveTo perform a systematic literature review (SLR) informing the European Lmmendations for the management of antiphospholipid syndrome (APS) in adults.MethodsA SLR through January 2018 was performed. Research questions were constructed using the Patient, Intervention, Comparator, Outcome (PICO) format. We included data from articles that reported on each relevant intervention. Summary effect estimates were calculated for direct comparison studies that matched the PICO question exactly, and for studies with the relevant intervention and comparator. When meta-analyses were available, we used these estimates.ResultsFrom 7534 retrieved articles (+15 from hand searches), 188 articles were included in the review. In individuals with high-risk antiphospholipid antibody (aPL) profile without prior thrombotic or obstetric APS, two meta-analyses showed a protective effect of low-dose aspirin (LDA) against thrombosis. Two randomised controlled trials (RCTs) and three cohort studies showed no additional benefit of treatment with vitamin K antagonists at target international normalised ratio (INR) 3–4 versus INR 2–3 in patients with venous thrombosis. In patients with arterial thrombosis, two RCTs and two cohort studies showed no difference in risk of recurrent thrombosis between the two target INR groups. One open-label trial showed higher rates of thrombosis recurrences in triple aPL-positive patients treated with rivaroxaban than those treated with warfarin. RCTs and cohort studies showed that combination treatment with LDA and heparin was more effective than LDA alone in several types of obstetric APS. SLR results were limited by the indirect evidence and the heterogeneity of patient groups for some treatments, and only a few high-quality RCTs.ConclusionWell-designed studies of homogeneous APS patient populations are needed.
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Arianto, Eko, Arry Rodjani, and Irfan Wahyudi. "COMPARISON OF KETOROLAC VERSUS DICLOFENAC AS TREATMENT FOR ACUTE RENAL COLIC: A SYSTEMATIC REVIEW AND A NETWORK META-ANALYSIS (DIRECT AND INDIRECT COMPARISON)." Indonesian Journal of Urology 28, no. 1 (January 15, 2021): 57–65. http://dx.doi.org/10.32421/juri.v28i1.667.
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Objective: The purpose of this study is to compare which analgesic is better between ketorolac and diclofenac. Material & Methods: A systematic search was conducted in Pubmed, Science Direct, Cochrane, EBSCO, Proquest database, and PICO analysis was used in determining the study question. The included article in the analysis was randomized controlled trials. Results: A total of 6 articles were included in the analysis, with no significant differences between ketorolac and diclofenac both in a direct comparison and indirect comparison (OR 2.74 [95%CI 0.72 – 10.43]; p= 0.14 and OR 0.51 [95%CI 0.29 – 0.91]; p= 0.49). Conclusion: Both ketorolac and diclofenac have the same efficacy in treating renal colic.
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Zhong, Duyi, Luisa Listmann, Maria-Elisabetta Santelia, and C.-Elisa Schaum. "Functional redundancy in natural pico-phytoplankton communities depends on temperature and biogeography." Biology Letters 16, no. 8 (August 2020): 20200330. http://dx.doi.org/10.1098/rsbl.2020.0330.
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Biodiversity affects ecosystem function, and how this relationship will change in a warming world is a major and well-examined question in ecology. Yet, it remains understudied for pico-phytoplankton communities, which contribute to carbon cycles and aquatic food webs year-round. Observational studies show a link between phytoplankton community diversity and ecosystem stability, but there is only scarce causal or empirical evidence. Here, we sampled phytoplankton communities from two geographically related regions with distinct thermal and biological properties in the Southern Baltic Sea and carried out a series of dilution/regrowth experiments across three assay temperatures. This allowed us to investigate the effects of loss of rare taxa and establish causal links in natural communities between species richness and several ecologically relevant traits (e.g. size, biomass production, and oxygen production), depending on sampling location and assay temperature. We found that the samples' biogeographical origin determined whether and how functional redundancy changed as a function of temperature for all traits under investigation. Samples obtained from the slightly warmer and more thermally variable regions showed overall high functional redundancy. Samples from the slightly cooler, less variable, stations showed little functional redundancy, i.e. function decreased when species were lost from the community. The differences between regions were more pronounced at elevated assay temperatures. Our results imply that the importance of rare species and the amount of species required to maintain ecosystem function even under short-term warming may differ drastically even within geographically closely related regions of the same ecosystem.
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Ganshorn, Heather. "A Librarian Consultation Service Improves Decision-Making and Saves Time for Primary Care Practitioners." Evidence Based Library and Information Practice 4, no. 2 (June 14, 2009): 148. http://dx.doi.org/10.18438/b8289j.
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A Review of:
McGowan, Jessie, William Hogg, Craig Campbell, and Margo Rowan. “Just-in-Time Information Improved Decision-Making in Primary Care: A Randomized Controlled Trial.” PLoS ONE 3.11 (2008): e3785. 10 Mar 2009
Objectives – To determine whether a point-of-care librarian consultation service for primary care practitioners (PCPs) improves the quality of PCPs’ decision-making; saves PCPs time; reduces the number of point-of-care questions that go unanswered due to time constraints; and is cost-effective. Overall PCP satisfaction with the service was also assessed.
Design – Randomized controlled trial.
Setting – Four Family Health Networks (FHNs) and 14 Family Health Groups (FHGs) in Ontario, Canada. These represent new models for primary care service delivery in Ontario.
Subjects – PCPs working within the selected FHNs and FHGs. The majority of these were physicians, but the sample also contained one resident, one nurse, and four nurse-practitioners.
Methods – Subjects were trained in the use of a Web-based query form or mobile device to submit their point-of-care questions electronically. They were also trained in query formulation using PICO (patient, intervention, comparison, and outcome).
Allocation was concealed by an independent company hired to manage data for the project. Participants were not randomized; rather the questions were randomized using a random-number generator.
To ensure blinding of the librarians, all questions submitted were answered by a librarian. Answers to questions in the intervention group were relayed by a third party to the practitioner within minutes. Answers to the questions in the control group were not communicated to the physician. Blinding of the PCP subjects was not possible, as they either received or did not receive an answer.
Subjects were asked to respond to a questionnaire 24 hours after submitting their question. If the question was in the control group, subjects were asked to indicate whether they had let the question remain unanswered or pursued an answer on their own. In order to assess cognitive impact of both librarian-provided information and self-sought information, respondents were asked to rate information on a scale from high positive to negative impact on decision making.
Two linear regression models were run on the data, with participant response time as the dependent variable in the first model, and librarian response time as the dependent variable in the second.
Main Results – The service received a total of 1,889 questions, of which 472 (25%) were randomized to the control group, and 1,417 (75%) to the intervention group. Analysis run on both groups found that the types and complexity of questions were similar between the two groups, as was librarian response time. Questions were rated for complexity (the rating scale is included in the article), and most (85%) had a Level 1 complexity rating, meaning there was only one concept listed for each PICO element.
The primary outcome measure was the amount of time required to answer the question. Average librarian time to respond to questions was 13.68 minutes per question. Average PCP time to find answers to their own questions was 20.29 minutes; however, subjects only attempted to answer 40.5% of control-group questions themselves. Cost-effectiveness analysis was run on these times, and the authors found that the average per-question salary cost for a librarian to answer these questions (based on 15 minutes per question) was $7.15, while average salary cost for a PCP to spend 15 minutes searching for information ranged from $20.75 to $27.69.
The results of the questionnaire indicated a significant positive impact of the information on clinician decision-making. Approximately 60% of the questions in the control group went unanswered, whereas all of the questions in the intervention group were answered. Of the questions answered by the information service, 63.7% of the answers were rated by participants as having a high positive impact on decision-making, versus 14.9% of answers to questions in the control group that practitioners sought out themselves. Seventeen percent of the answers were rated as having a moderate positive impact in the intervention group, versus 5.9% in the control group. Only 7.8% of answers in the intervention group were rated as having no impact, versus 24.8% of answers in the control group. A negative impact (where practitioners found too much or too little information or information that they disagreed with or felt was harmful) was found for 7.7% of librarian-provided answers, compared with 44.9% of practitioner-sought answers.
Satisfaction was very high, according to the exit satisfaction survey, with 86% agreeing that the service had a positive impact on decision-making, and 83% stating that relevant answers were provided in an appropriate time frame. Most participants (72%) would consider using such a service, and 33% indicated they would be willing to pay for this type of service.
Conclusion – A point-of-care reference service, in which librarians answer primary care practitioners’ questions within minutes, has a very positive impact on clinical decision making and a high rate of client satisfaction. This system saves PCPs time, which may allow them to spend more time with patients. In supporting good clinical decision making, the service may also decrease the need for referrals and further tests. The service is cost-effective, as librarians find better quality information than practitioners, and they do it faster, on a lower per-hour salary.
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Narayan, Nishant, Victor Vega-Garita, Zian Qin, Jelena Popovic-Gerber, Pavol Bauer, and Miro Zeman. "The Long Road to Universal Electrification: A Critical Look at Present Pathways and Challenges." Energies 13, no. 3 (January 21, 2020): 508. http://dx.doi.org/10.3390/en13030508.
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Nearly 840 million people still lack access to electricity, while over a billion more have an unreliable electricity connection. In this article, the three different electrification pathways—grid extension, centralized microgrids, and standalone solar-based solutions, such as pico-solar and solar home systems (SHS)—are critically examined while understanding their relative merits and demerits. Grid extension can provide broad scale access at low levelized costs but requires a certain electricity demand threshold and population density to justify investments. To a lesser extent, centralized (off-grid) microgrids also require a minimum demand threshold and knowledge of the electricity demand. Solar-based solutions are the main focus in terms of off-grid electrification in this article, given the equatorial/tropical latitudes of the un(der-)electrified regions. In recent times, decentralized solar-based off-grid solutions, such as pico-solar and SHS, have shown the highest adoption rates and promising impetus with respect to basic lighting and electricity for powering small appliances. However, the burning question is—from lighting a million to empowering a billion—can solar home systems get us there?The two main roadblocks for SHS are discussed, and the requirements from the ideal electrification pathway are introduced. A bottom-up, interconnected SHS-based electrification pathway is proposed as the missing link among the present electrification pathways.
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Yuliana, Andi, Rini Rachmawaty, and Ariyanti Saleh. "EFEKTIVITAS PENERAPAN INTAGRATED CLINICAL PATHWAY PADA PENYAKIT PARU: LITERATURE REVIEW." Care : Jurnal Ilmiah Ilmu Kesehatan 10, no. 1 (March 28, 2022): 75–85. http://dx.doi.org/10.33366/jc.v10i1.2471.
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Globally, lung disease is one of the contributors to the increase in inpatients and the use of health facilities in hospitals. This literature review aims to identify the effectiveness of implementing integrated clinical pathways in lung disease. Methods: The design of this research is a literature review. Search articles using Pubmed, Ebsco, Cochrane Library, and Proquest databases. Structured research questions using the PICO method, and search keywords based on the database in MeSH Term. The inclusion criteria are focused on the application of integrated clinical pathways, applied to health care facilities, applied to lung disease, published in the last 10 years, and in English. There were 3582 articles found, and only 8 articles were included which matched the research question. Results: There were 8 articles included in this study. From the results of a critical assessment of the included articles, the application of ICP in lung disease can reduce patient length of stay, reduce patient care costs, reduce the number of patient readmissions, and reduce drug use in hospitals. Conclusion: The application of ICP in lung disease improves patient outcomes, therefore ICP can be recommended to health care agencies, especially health management.
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Cook, Aaron M., G. Morgan Jones, Gregory W. J. Hawryluk, Patrick Mailloux, Diane McLaughlin, Alexander Papangelou, Sophie Samuel, et al. "Guidelines for the Acute Treatment of Cerebral Edema in Neurocritical Care Patients." Neurocritical Care 32, no. 3 (May 15, 2020): 647–66. http://dx.doi.org/10.1007/s12028-020-00959-7.
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Background Acute treatment of cerebral edema and elevated intracranial pressure is a common issue in patients with neurological injury. Practical recommendations regarding selection and monitoring of therapies for initial management of cerebral edema for optimal efficacy and safety are generally lacking. This guideline evaluates the role of hyperosmolar agents (mannitol, HTS), corticosteroids, and selected non-pharmacologic therapies in the acute treatment of cerebral edema. Clinicians must be able to select appropriate therapies for initial cerebral edema management based on available evidence while balancing efficacy and safety. Methods The Neurocritical Care Society recruited experts in neurocritical care, nursing, and pharmacy to create a panel in 2017. The group generated 16 clinical questions related to initial management of cerebral edema in various neurological insults using the PICO format. A research librarian executed a comprehensive literature search through July 2018. The panel screened the identified articles for inclusion related to each specific PICO question and abstracted necessary information for pertinent publications. The panel used GRADE methodology to categorize the quality of evidence as high, moderate, low, or very low based on their confidence that the findings of each publication approximate the true effect of the therapy. Results The panel generated recommendations regarding initial management of cerebral edema in neurocritical care patients with subarachnoid hemorrhage, traumatic brain injury, acute ischemic stroke, intracerebral hemorrhage, bacterial meningitis, and hepatic encephalopathy. Conclusion The available evidence suggests hyperosmolar therapy may be helpful in reducing ICP elevations or cerebral edema in patients with SAH, TBI, AIS, ICH, and HE, although neurological outcomes do not appear to be affected. Corticosteroids appear to be helpful in reducing cerebral edema in patients with bacterial meningitis, but not ICH. Differences in therapeutic response and safety may exist between HTS and mannitol. The use of these agents in these critical clinical situations merits close monitoring for adverse effects. There is a dire need for high-quality research to better inform clinicians of the best options for individualized care of patients with cerebral edema.
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Mello, Luane Marques de, and Maria Cristiane Barbosa Galvão. "Searching for health information for academic and clinical purposes: possibilities and challenges." Research, Society and Development 11, no. 3 (March 1, 2022): e41011326726. http://dx.doi.org/10.33448/rsd-v11i3.26726.
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Studies in different countries indicate that students and health professionals have difficulties in seeking scientific information for academic and clinical use. This article aims to present the main intellectual stages of information search for clinical and academic purposes, as well as the possibilities and challenges that arise in each of the stages. We used a descriptive qualitative design based on a selective literature review, presentation of practical examples and some solutions to doubts related to health information seeking. The following stages of information search were presented: defining what the researcher wants to know; transforming the PICO research question into a database search strategy; defining where to search for the information; sources used in the health field for clinical and/or academic purposes. The process of information search demands specific intellectual decisions for each clinical or research situation. Therefore, just following information search manuals may not be enough to achieve a satisfactory result. It is necessary to bring to the level of consciousness the objectives of the search, the choice of sources, and the selection of the best information to answer the initial research question.
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Zou, Chuan, Guobin Su, Yuchi Wu, Fuhua Lu, Wei Mao, and Xusheng Liu. "Astragalusin the Prevention of Upper Respiratory Tract Infection in Children with Nephrotic Syndrome: Evidence-Based Clinical Practice." Evidence-Based Complementary and Alternative Medicine 2013 (2013): 1–10. http://dx.doi.org/10.1155/2013/352130.
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Aims. To explore whetherAstragalusor its formulations could prevent upper respiratory infection in children with nephrotic syndrome and how best to use it.Methods. We transformed a common clinical question in practice to an answerable question according to the PICO principle. Databases, including the Cochrane Library (Issue 5, 2012), PUBMED (1966–2012.8), CBM (1978–2012.8), VIP (1989–2012.8), and CNKI (1979–2012.8), were searched to identify Cochrane systematic reviews and clinical trials. Then, the quality of and recommendations from the clinical evidence were evaluated using the GRADEpro software.Results. The search yielded 537 papers. Only two studies with high validity were included for synthesis calculations. The results showed thatAstragalusgranules could effectively reduce URTI in children with nephrotic syndrome compared with prednisone treatment alone (23.9% versus 42.9%; RR = 0.56 and 95% CI = 0.33–0.93). The dose ofAstragalusgranules was 2.25 gram (equivalent to 15 gram crudeAstragalus) twice per day, at least for 3–6 months. The level of evidence quality was low, but we still recommended the evidence to the patient according to GRADEpro with the opinion of the expert. Followup showed the incidence of URTI in this child decreased significantly.Conclusions.Astragalusgranules may reduce the incidence of URTI in children with nephrotic syndrome.
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Chaves Castro, Álvaro H. "Análisis sobre la evolución del COVID-19 en Colombia: ¿se alcanzará el pico de contagio?" Tiempo y economía 8, no. 1 (January 2021): 123–60. http://dx.doi.org/10.21789/24222704.1672.
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An analysis of the evolution of daily COVID-19 cases and number of deaths in Colombia and some Colombian cities is carried using official information reported by the Ministry of Health. This seeks to answer the following question: Considering the current trajectory of the new coronavirus, is it possible to estimate the future peak of infections? From the construction of a panel data structure, some models with a time quadratic trend are estimated for the number of infections and deaths logarithm. The estimation of such dynamics by the rolling window regression method shows a good fit, allowing to estimate the approximate date for the peak of the epidemic based on the new officially reported cases. Some factors associated with the progression of the pandemic are estimated, especially the effect of the speed of contagion (effective reproduction rate, Ro) on the future trajectory of daily infections. In addition, an attempt to estimate the impact of preventive social distancing measures adopted by national and regional authorities is performed. Results show that the peak of the pandemic in Colombia will be reached approximately at the end of August; finding that agrees with more elaborate epidemiological studies. The average number of new daily cases at the peak of the pandemic in Colombia would reach more than 10,000, while the maximum number of deaths would be 44,471. Estimates about the impact of confinement measures show that it is possible to delay the peak and reduce the number of infections and deaths.
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Guerreiro, Maria Auxiliadora Ribeiro de Jesus, Selma Petra Chaves Sá Guerreiro, Kyra Vianna Alochio, and Martha Tudrej Sattler Ribeiro. "Telecuidado como uma estratégia de saúde para a adesão do paciente com insuficiência cardíaca – revisão integrative." Enfermería Global 19, no. 2 (March 15, 2020): 591–639. http://dx.doi.org/10.6018/eglobal.377801.
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Objetivo: Identificar estrategias de telecuidado para pacientes con insuficiencia cardíaca que colaboran para la adhesión al tratamiento.Material y Método: Revisión integrativa de la literatura realizada en las bases de datos CINAHL, PubMed, Scielo y LILACS. La elaboración del problema fue guiada por la estrategia PICO que originó la siguiente pregunta: ¿Cuáles son las estrategias del telecuidado para los pacientes con insuficiencia cardíaca que contribuyen a su adhesión al tratamiento?Resultados: Dieciséis artículos atendieron a los criterios definidos por el estudio y por lo tanto, participaron del análisis de esta revisión.Conclusión: El telecuidado posibilita el acompañamiento de un número mayor de pacientes, contribuyendo al control de signos y síntomas de la insuficiencia cardiaca. Favorece la optimización de los tratamientos farmacológico y no farmacológico disminuyendo tasas de re-hospitalización y mortalidad. Objective: Identify tele-monitoring strategies for patients with heart failure who collaborate for adherence when it comes to treatment.Material and Method: Integrative review of the literature carried out in the databases CINAHL, PubMed, Scielo and LILACS. The elaboration of the problem was guided by the PICO strategy that gave rise to the following question: "What are the tele-monitoring strategies for patients with heart failure that contribute to their adherence to treatment?".Results: Sixteen articles met the criteria defined by the study and, therefore, participated in the analysis of this review.Conclusion: Tele-monitoring allows the monitoring of a larger number of patients, contributing to the control of signs and symptoms of heart failure. Also, It favors the optimization of pharmacological and non-pharmacological treatments, reducing rates of rehospitalization and mortality.
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Al-Thobity, Ahmad M., Ahmad Kutkut, and Khalid Almas. "Microthreaded Implants and Crestal Bone Loss: A Systematic Review." Journal of Oral Implantology 43, no. 2 (April 1, 2017): 157–66. http://dx.doi.org/10.1563/aaid-joi-d-16-00170.
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This systematic literature review investigated the effect of microthreaded-neck dental implants on crestal bone loss. Using the participants, interventions, comparison groups, outcomes, and study design (PICO) system, we addressed the following focused question: Do microthreaded-neck dental implants positively affect the crestal bone level around dental implants? We searched 3 electronic databases to find articles published between January 1995 and June 2016 that contained any combination of the following keywords: dental implant, microthread, microthreaded, crestal bone level, crestal bone loss, and alveolar bone level. We excluded case reports, review articles, letters to the editor, commentaries, and articles published in a language other than English. We found a total of 70 articles. After eliminating duplicates and applying PICO eligibility criteria, we selected only articles that reported the results of randomized controlled trials, prospective or retrospective cohort studies, case control studies, cross-sectional studies, or other types of clinical trials that compared the microthreaded implant design with other implant designs. We were left with 23 articles for review. The 23 articles reported crestal bone loss ranging from .05 mm to .9 mm, with a range of 12 to 96 months of follow-up. Less crestal bone was lost with dental implants that had a microthreaded neck design than with machined-surface or conventional rough-surface dental implants. Thus, microthreaded dental implants are a better choice than are implants with other designs. Future studies should use standardized imaging techniques to evaluate the placement of these implants in bone-augmented sites.
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Ihwanto, Nur, and Mashud Mashud. "Game Based Learning in Physical Education Sport and Health Subject." TEGAR: Journal of Teaching Physical Education in Elementary School 5, no. 1 (October 31, 2021): 10–18. http://dx.doi.org/10.17509/tegar.v5i1.34905.
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The purpose this article review was to examine and analyze suitable learning methods for students aged 6 to 12 years in Elementary School to improve their learning outcomes in learning Physical Education Sports and Health subjects. The reviewed articles were selected from Google Scholar database published in the last 10 years. The research question and journal search employed PICO method, while the PRISMA flow chart was used to identify articles through data filtering and extraction process. Of 113 downloaded articles, the remaining 12 articles were the final results passing the screening and extraction process. The articles were then analyzed for discussion. Learning Physical Education Sports and Health using game-based method is compatible with the character of students aged 6 to 12 years in Elementary School level and has succeeded in improving student learning outcomes and increasing their motivation to participate in learning.
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Silva, Alessandra Maria de Araújo, Victor Hugo Alves Mascarenhas, Sarah Nilkece Mesquita Araújo, Raylane da Silva Machado, Ana Maria Ribeiro dos Santos, and Elaine Maria Leite Rangel Andrade. "Mobile technologies in the Nursing area." Revista Brasileira de Enfermagem 71, no. 5 (October 2018): 2570–78. http://dx.doi.org/10.1590/0034-7167-2017-0513.
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ABSTRACT Objective: To identify in the literature studies on mobile technologies in Nursing. Method: Integrative literature review in which was used the Population, Interest and Context (PICo) strategy, the tool of the National Library of Medicine for formulation of the research question, and search without a determined period of time in the following bibliographic databases: Medical Literature and Retrieval System onLine/PubMed®), Cumulative Index to Nursing & Allied Health Literature (CINAHL), SCOPUS (Elsevier), Latin American and Caribbean Literature in Health Sciences (LILACS) and Nursing Database (BDENF). Data collection period was from January to March 2017. Results: Fifteen articles were selected, in which were addressed mobile technologies in Nursing for nurses, undergraduate students and patients. Conclusion: Mobile technologies in Nursing are a recent theme and enable care data sharing, experience acquisition by undergraduate students and patient empowerment.
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Sgarbossa, Nadia, Matías Ibáñez Cobaisse, Gabriel González Cianciulli, Javier Bracchiglione, and Juan Víctor Ariel Franco. "Systematic reviews: Key concepts for health professionals." Medwave 22, no. 09 (October 28, 2022): e2622-e2622. http://dx.doi.org/10.5867/medwave.2022.09.2622.
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The exponential growth of currently available evidence has made it necessary to collect, filter, critically appraise, and synthesize biomedical information to keep up to date. In this sense, systematic reviews are a helpful tool and can be reliable sources to assist in evidence-based decision-making. Systematic reviews are defined as secondary research or syntheses of evidence focused on a specific question that -- based on a structured methodology -- make it possible to identify, select, critically appraise, and summarize findings from relevant studies. Systematic reviews have several potential advantages, such as minimizing biases or obtaining more accurate results. The reliability of the evidence presented in systematic reviews is determined, amongst other factors, by the quality of their methodology and the included studies. To conduct a systematic review, a series of steps must be followed: the formulation of a research question using the participants, interventions, comparisons, outcomes (PICO) format; an exhaustive literature search; the selection of relevant studies; the critical appraisal of the data obtained from the included studies; the synthesis of results, often using statistical methods (meta-analysis); and finally, estimating the certainty of the evidence for each outcome. In this methodological note, we will define the basic concepts of systematic reviews, their methods, and their limitations.
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Lima, Paola de, Renata Souza e. Silva, Denis Guilherme Guedert, Gilberto dos Santos Cerqueira, and Emmanuel Prata de Souza. "The participation of human anatomy monitoring in the teaching and student learning process: a critical review of the literature." Research, Society and Development 11, no. 7 (May 26, 2022): e33511730088. http://dx.doi.org/10.33448/rsd-v11i7.30088.
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Implemented in Higher Education Institutions (HEIs) for some years, the monitoring activity is understood as a pedagogical resource to strengthen the teaching and learning process through the establishment of new pedagogical and experiential practices and experiences. In this work we aim, through an integrative review, to describe the monitoring activity of human anatomy in the process of teaching and student learning. The PICo strategy was used to form the guiding question, the results were presented through the Prisma Flow diagram. The databases consulted were Scielo, Portal Capes and Google Scholar, searching for articles from 2011 to 2021. Our results show that in addition to generating a strengthening of learning, the monitoring activity provides an incentive for teaching and is a collaborative and cooperative moment. between peers making the teaching and learning process active. In the search for a more critical and reflective professional future for the demands of today's world.
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Martins, Christine Men, Milena Filippini Knecht, Larissa dos Santos de Moraes, and Victor Eduardo de Souza Batista. "Regenerative endodontic treatment performed with platelet-rich plasma presents better periapical healing than only induced blot clot: a systematic review." Research, Society and Development 10, no. 13 (October 13, 2021): e147101321219. http://dx.doi.org/10.33448/rsd-v10i13.21219.
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This study comprehensively reviewed two different treatments for regenerative endodontic: platelet-rich plasma and induced blot clot, in regarding to periapical healing. Two investigators performed a systematic review. MEDLINE/PubMed, Cochrane Library and Scopus supplied relevant data from studies published until December 2020 to answer the PICO question. Primary outcome was periapical healing. Eight randomized clinical trials fulfilled eligibility criteria. Primary outcome indicated that platelet-rich plasma results in similar or better periapical healing compared to blot clot group. The reported failures were related to blot clot group due to incomplete radiographic parameters, pain and reinfection; however, few cases of unsuccess were reported to platelet-rich plasma group. Only two studies observed better results to blot clot group in relation to increase of radiographic area and partial pulp canal obliteration. This review showed that procedures using platelet-rich plasma were successful in treating permanent teeth with root development.
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Yan, Xiu-feng, Qing Ni, Jun-ping Wei, and Hao Xu. "Evidence-based practice method of integrative Chinese and Western medicine based on literature retrieval through PICO question and complementary and alternative medicine topics." Chinese Journal of Integrative Medicine 16, no. 6 (November 26, 2010): 542–48. http://dx.doi.org/10.1007/s11655-010-0570-5.
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Montero, Javier. "A Review of the Major Prosthetic Factors Influencing the Prognosis of Implant Prosthodontics." Journal of Clinical Medicine 10, no. 4 (February 17, 2021): 816. http://dx.doi.org/10.3390/jcm10040816.
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Background: The treatment plan of prosthetic restorations supported by dental implants requires comprehensive scientific knowledge to deliver prostheses with good prognosis, even before the implant insertion. This review aims to analyze the main prosthetic determinants of the prognosis of implant-supported prostheses. Methods: A comprehensive review of the literature was conducted with a PICO (Patient Intervention Comparison Outcomes) question: “For partially or complete edentulous subjects treated with implant-supported prostheses, which prosthetic factors could affect clinical outcomes?”. A literature search was performed electronically in PubMed (MEDLINE), Scopus and Cochrane Library with the following equation [PROGNOS * OR RISK] FACTOR IMPLANT DENTAL, and by hand search in relevant journals and throughout the selected papers. Results: This revision was carried out based on 50 papers focused on several prosthodontics-related risk factors that were grouped as follows: implant-connection, loading protocol, transmucosal abutments, prosthetic fit, provisionalization, type of retention, impression technique, fabrication technique, and occlusion. More than a half of the studies were systematic reviews (30%), meta-analysis (16%), or prospective evaluations of prosthesis with various kinds of events (18%). However, narrative reviews of literature (14%) and in vitro/animal studies (16%) were also found. Conclusions: The current literature provides insufficient evidence for most of the investigated topics. However, based on the accumulated data, it seems reasonable to defend that the best treatment approach is the use of morse taper implants with transmucosal abutments, recorded by means of rigidly splinted copings through the pick-up technique, and screwed by milled prosthesis occlusally adjusted to minimize functional overloading.
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Alarcón Gil, María Teresa, Sonia Osorio Toro, and Gloria Patricia Baena Caldas. "THE EVIDENCE-BASED MEDICINE PICO STRATEGY APPLIED TO DENTISTRY USING MESH, EMTREE AND DECS." Revista Facultad de Odontología 31, no. 1-2 (July 9, 2019). http://dx.doi.org/10.17533/udea.rfo.v31n1-2a8.
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Introduction: the PICO mnemonic is an evidence-based medicine tool that helps formulate the research questions needed to conduct the right search for scientific information. To properly classify this information, controlled languages or thesauruses are used for information retrieval. The aim was to identify whether the PICO search strategy in evidence-based medicine using the MeSH, Emtree and DeCS thesauruses answers a research question in the field of dentistry. Methods: to carry out the PICO strategy, a research question was formulated, identifying the natural language terms for each component of the PICO acronym, which were normalized into the three thesauruses to create the search equations. Results: 43 results were foundon Medline through PubMed, 5 on Embase, and 0 on LILACS. There were 4 original articles that answer the research question, proving to be an effective strategy for finding clinical evidence. Conclusion: this study shows that the strategy helps obtain results to answer the question posed. It should be noted that, in order to successfully search and retrieve information, researchers should use the PICO strategy and get familiar with the thesauruses that help structure search equations in the various bibliographic databases.
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Probst, P., D. Merz, M. Joos, and R. Klotz. "Finding the best available evidence in pancreatic surgery – the EVIglance randomised controlled trial." British Journal of Surgery 109, Supplement_3 (May 31, 2022). http://dx.doi.org/10.1093/bjs/znac178.007.
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Abstract Objective Profound and thorough literature search is a vital element of evidence-based medicine. However, increasing number of publications and limited time make it hard to find the best available evidence. The objective of this randomised controlled trial (RCT) was to demonstrate the superiority of the ISGPS Evidence Map of Pancreatic Surgery (via EVIglance on www.evidencemap.surgery) compared to a conventional literature search via PubMed for answering clinically relevant questions in pancreatic surgery. Methods A single-centre, blinded, cross-over RCT including medical students, residents and consultants as participants was performed. Participants conducted literature searches with two predefined PICO (Patient, Intervention, Control, Outcome) questions, one with PubMed and the other with EVIglance. The order of the search tools and the PICO questions were assigned by randomisation. Primary endpoint was time in minutes until a synopsis was made regarding the PICO question. The synopsis was characterised by the direction of the effect and the certainty of evidence. Three times 28 participants were needed to show a minimal difference of 3 minutes at a level of significance of alpha = 1.67%. Furthermore, the correct number of RCTs found by participants that were relevant to answer the PICO question was analysed. Results Each 28 medical students, residents and consultants were randomised and analysed. A synopsis for the PICO question was found with PubMed after 10.8 minutes and with EVIglance after 1.7 minutes (95%-CI for difference: 9.9 to 8.3 minutes; p<0.001). EVIglance answered the PICO significantly faster in all groups (medical students, residents and consultants) even after Bonferroni correction. Participants were able to guess both the direction of the effect (95% vs 48%; p<0.001) and the certainty of evidence (99% vs 30%; p<0.001) better with EVIglance than with PubMed. The correct number of relevant RCTs to answer the PICO question was found more often with EVIglance compared to PubMed (99% vs 15%; p<0.001). Conclusion Pancreatic surgeons find best available evidence faster via EVIglance on www.evidencemap.surgery. Furthermore, a synopsis made from EVIglance is more concise regarding direction of effect and certainty of evidence. Given the advantages of EVIglance it may be considered the new gold standard for finding best available evidence in pancreatic surgery.
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Kloda, Lorie A., Jill T. Boruff, and Alexandre Soares Cavalcante. "A comparison of patient, intervention, comparison, outcome (PICO) to a new, alternative clinical question framework for search skills, search results, and self-efficacy: a randomized controlled trial." Journal of the Medical Library Association 108, no. 2 (April 1, 2020). http://dx.doi.org/10.5195/jmla.2020.739.
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Objective: In educating students in the health professions about evidence-based practice, instructors and librarians typically use the patient, intervention, comparison, outcome (PICO) framework for asking clinical questions. A recent study proposed an alternative framework for the rehabilitation professions. The present study investigated the effectiveness of teaching the alternative framework in an educational setting.Methods: A randomized controlled trial was conducted with students in occupational therapy (OT) and physical therapy (PT) to determine if the alternative framework for asking clinical questions was effective for identifying information needs and searching the literature. Participants were randomly allocated to a control or experimental group to receive ninety minutes of information literacy instruction from a librarian about formulating clinical questions and searching the literature using MEDLINE. The control group received instruction that included the PICO question framework, and the experimental group received instruction that included the alternative framework.Results: There were no significant differences in search performance or search skills (strategy and clinical question formulation) between the two groups. Both the control and experimental groups demonstrated a modest but significant increase in information literacy self-efficacy after the instruction; however, there was no difference between the two groups.Conclusion: When taught in an information literacy session, the new, alternative framework is as effective as PICO when assessing OT and PT students’ searching skills. Librarian-led workshops using either question formulation framework led to an increase in information literacy self-efficacy post-instruction.
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Shultz, Laura, and Erik Fausak. "Borrelia burgdorferi exposure in coyotes: an indicator of B. burgdorferi levels in urban versus rural environments." Veterinary Evidence 7, no. 1 (February 16, 2022). http://dx.doi.org/10.18849/ve.v7i1.444.
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PICO question
Do wild coyotes in the US that are in an urban habitat compared to a rural habitat have a higher prevalence of Borrelia burgdorferi seroconversion?
Clinical bottom line
Category of research question
Prevalence
The number and type of study designs reviewed
Two papers, both utilising a cross-sectional study design
Strength of evidence
Zero
Outcomes reported
The relevant studies provide very limited to no evidence towards answering this PICO question. In one, while the absolute percentage of Borrelia-antibody-positive canines (including dogs in addition to coyotes) is higher in metropolitan areas, the effect was not found to be statistically significant, possibly due to their small sample sizes. In the second study, prevalence of antibodies against Borrelia was compared between different rural habitats, but no urban coyotes were tested as a comparison and thus the PICO question cannot be evaluated
Conclusion
There is a knowledge gap concerning the prevalence of Borrelia in coyotes and how it differs between urban and rural environments. Wild coyotes could be used as a sentinel species of Lyme disease activity and to assess potential for domestic pet and human infections, which would inform clinical differential diagnoses as well as testing and vaccination recommendations. More studies are needed before this PICO question can be answered in a confident manner
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
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Mapuvire, Tafara. "In dogs weighing under 15 Kg with unilateral cranial cruciate ligament disease, does tibial tuberosity advancement lead to better long-term functional outcomes than lateral fabellar suture?" Veterinary Evidence 5, no. 2 (May 13, 2020). http://dx.doi.org/10.18849/ve.v5i2.297.
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PICO question
In dogs weighing under 15 kg with unilateral cranial cruciate ligament disease, does tibial tuberosity advancement lead to better long-term functional outcomes than lateral fabellar suture?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
There were no papers that answered the PICO question
Strength of evidence
Zero
Outcomes reported
Between TTA and LFS none of the techniques was shown to provide better long-term functional outcomes than the other in dogs weighing less than 15 kg
Conclusion
Given the absence of evidence answering the PICO question, choice and recommendation of procedure between TTA and LFS in dogs weighing under 15 kg should be guided by what the surgeon deems to be in the best interest of the patient
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
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Wang, Qianying, Jing Liao, Mirella Lapata, and Malcolm Macleod. "PICO entity extraction for preclinical animal literature." Systematic Reviews 11, no. 1 (September 30, 2022). http://dx.doi.org/10.1186/s13643-022-02074-4.
Full textAbstract:
Abstract Background Natural language processing could assist multiple tasks in systematic reviews to reduce workflow, including the extraction of PICO elements such as study populations, interventions, comparators and outcomes. The PICO framework provides a basis for the retrieval and selection for inclusion of evidence relevant to a specific systematic review question, and automatic approaches to PICO extraction have been developed particularly for reviews of clinical trial findings. Considering the difference between preclinical animal studies and clinical trials, developing separate approaches is necessary. Facilitating preclinical systematic reviews will inform the translation from preclinical to clinical research. Methods We randomly selected 400 abstracts from the PubMed Central Open Access database which described in vivo animal research and manually annotated these with PICO phrases for Species, Strain, methods of Induction of disease model, Intervention, Comparator and Outcome. We developed a two-stage workflow for preclinical PICO extraction. Firstly we fine-tuned BERT with different pre-trained modules for PICO sentence classification. Then, after removing the text irrelevant to PICO features, we explored LSTM-, CRF- and BERT-based models for PICO entity recognition. We also explored a self-training approach because of the small training corpus. Results For PICO sentence classification, BERT models using all pre-trained modules achieved an F1 score of over 80%, and models pre-trained on PubMed abstracts achieved the highest F1 of 85%. For PICO entity recognition, fine-tuning BERT pre-trained on PubMed abstracts achieved an overall F1 of 71% and satisfactory F1 for Species (98%), Strain (70%), Intervention (70%) and Outcome (67%). The score of Induction and Comparator is less satisfactory, but F1 of Comparator can be improved to 50% by applying self-training. Conclusions Our study indicates that of the approaches tested, BERT pre-trained on PubMed abstracts is the best for both PICO sentence classification and PICO entity recognition in the preclinical abstracts. Self-training yields better performance for identifying comparators and strains.
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Alzola, Rafael, and Sarah Louise Freeman. "Comparing Rest Alone to Bandaging and Rest in Horses With Superficial Digital Flexor Tendinopathy." Veterinary Evidence 4, no. 3 (August 6, 2019). http://dx.doi.org/10.18849/ve.v4i3.234.
Full textAbstract:
<strong>PICO question</strong><br /><p>In horses with superficial digital flexor tendonitis is bandaging and rest compared to rest alone more effective at promoting healing?</p><strong>Clinical bottom line</strong><br /><p>There is currently a lack of scientific evidence to suggest that bandaging promotes effective tendon healing following injury. However, rigid bandages significantly limit lesion propagation in equine superficial digital flexor (SDF) tendinopathies. The result of this PICO question suggests that a short period (ten days) of cast immobilisation during the initial inflammatory phase of the injury improves prognosis by limiting lesion propagation. The level of confidence in the outcomes from the body of evidence in the four studies identified is moderate.</p><br /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" />
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Baughman, Robert P., Dominique Valeyre, Peter Korsten, Alexander G. Mathioudakis, Wim A. Wuyts, Athol Wells, Paola Rottoli, et al. "ERS clinical practice guidelines on treatment of sarcoidosis." European Respiratory Journal, June 17, 2021, 2004079. http://dx.doi.org/10.1183/13993003.04079-2020.
Full textAbstract:
BackgroundThe major reasons to treat sarcoidosis are to lower the morbidity and mortality risk or to improve quality of life (QoL). The indication for treatment varies depending on which manifestation is the cause of symptoms: lungs, heart, brain, skin, or other manifestations. While glucocorticoids (GC) remain the first choice for initial treatment of symptomatic disease, prolonged use is associated with significant toxicity. GC-sparing alternatives are available. The presented treatment guideline aims to provide guidance to physicians treating the very heterogenous sarcoidosis manifestations.Materials and MethodsA European Respiratory Society Task Force (TF) committee composed of clinicians, methodologists, and patients with experience in sarcoidosis developed recommendations based on the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) methodology. The committee developed eight PICO (Patients, Intervention, Comparison, Outcomes) questions and these were used to make specific evidence-based recommendations.ResultsThe TF committee delivered twelve recommendations for seven PICOs. These included treatment of pulmonary, cutaneous, cardiac, and neurologic disease as well as fatigue. One PICO question regarding small fiber neuropathy had insufficient evidence to support a recommendation. In addition to the recommendations, the committee provided information on how they use alternative treatments, when there was insufficient evidence to support a recommendation.ConclusionsThere are many treatments available to treat sarcoidosis. Given the diverse nature of the disease, treatment decisions require an assessment of organ involvement, risk for significant morbidity, and impact on QoL of the disease and treatment.MessageAn evidence based guideline for treatment of sarcoidosis is presented. The panel used the GRADE approach and specific recommendations are made. A major factor in treating patients is the risk of loss of organ function or impairment of quality of life.
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Borisoot, Mullika. "In pregnant bitches, is elective caesarean section more effective than vaginal delivery at improving puppy survival?" Veterinary Evidence 5, no. 3 (August 13, 2020). http://dx.doi.org/10.18849/ve.v5i3.319.
Full textAbstract:
PICO question
In pregnant bitches due to whelp, is elective caesarean section more effective than vaginal delivery to improve puppy survival?
Clinical bottom line
Category of research question
The category of the research question is regarding the incidence of puppy mortalities as a result of vaginal delivery, emergency caesarean section and elective caesarean section.
The number and type of study designs reviewed
Two retrospective articles were reviewed and critically appraised; one retrospective study with high single canine breed bias and one study on different canine breeds but limited support in directly answering the PICO question.
Strength of evidence
The studies selected both had strong uses of experimental designs but together provided weak evidence to determine a definitive answer to the PICO question.
Outcomes reported
The outcomes from both retrospective studies suggests that the mortality rates of newborn puppies can be reduced if pregnant bitches are scheduled ahead for elective caesareans, in comparison to undergoing an emergency caesarean section when complications develop, particularly in breeds with higher risks of dystocia. Therefore, there is some evidence to support that it may be advantageous to consider the breed, age and overall health of the bitch during pregnancy to determine whether elective caesarean sections, for the safe delivery of puppies, should be considered.
Conclusion
There are currently insufficient studies, literatures and evidence in veterinary medicine for caesarean sections to become a routine procedure in first opinion practices. Future prospective studies should be conducted and include the optimum anaesthetic protocols with the lowest associated risks for the pregnant bitch and puppies.
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
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Johnson, Sery, and Wanda Gordon-Evans. "In dogs with uncomplicated corneal ulcers, do antibacterial eye drops reduce the risk of infection?" Veterinary Evidence 6, no. 4 (November 17, 2021). http://dx.doi.org/10.18849/ve.v6i4.389.
Full textAbstract:
PICO question
In dogs with uncomplicated corneal ulcers does treatment with prophylactic antibacterial eye drops reduce the risk of secondary infection when compared to no treatment with prophylactic antibacterial eye drops?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
Zero
Strength of evidence
Zero
Outcomes reported
None
Conclusion
There were no published papers found to address the PICO
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
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Sukkarieh-Haraty, Ola, and Nancy Hoffart. "Integrating Evidence-Based Practice into a Lebanese Nursing Baccalaureate Program: Challenges and Successes." International Journal of Nursing Education Scholarship 14, no. 1 (October 3, 2017). http://dx.doi.org/10.1515/ijnes-2017-0026.
Full textAbstract:
AbstractEvidence-based practice (EBP) is defined as “the conscientious use of current best evidence in making clinical decisions about patient care.” This paper describes how we have developed the evidence-based practice concept and integrated it into two courses at two different levels of the BSN curriculum. Students apply EBP knowledge and process by using the PICO clinical question (Population, Intervention, Comparison and Outcome), whereby they observe a selected clinical skill, and then compare their observations to hospital protocol and against the latest evidence-based practice guidelines. The assignment for the second course requires students to pick a more complex clinical skill and to support proposed changes in practice with scholarly literature. Assessment of student learning and course evaluation has shown that the overall experience of integrating EBP projects into the curriculum is fruitful for students, clinical agencies, and faculty.
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Hawes, Connor, and Kali Lazzerini. "In dogs undergoing extrahepatic portosystemic shunt attenuation, does pretreatment with levetiracetam reduce postoperative seizure incidence?" Veterinary Evidence 7, no. 3 (August 17, 2022). http://dx.doi.org/10.18849/ve.v7i3.581.
Full textAbstract:
PICO question
PICO
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
Four papers were critically reviewed. All were retrospective cohort studies
Strength of evidence
Moderate
Outcomes reported
In one paper levetiracetam was found to reduce the risk of post-attenuation seizures. In the remaining three papers no difference was found between the frequency of post-attenuation seizures and the use of levetiracetam
Conclusion
That prophylactic levetiracetam is not indicated for the use of preventing post-attenuation seizures in dogs surgically treated for extrahepatic portosystemic shunts
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.