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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.

ABSTRACT: 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. 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. 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. 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.

SUBMITTER: Kloda LA

PROVIDER: S-EPMC7069809 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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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.

Kloda Lorie A LA Boruff Jill T JT Cavalcante Alexandre Soares AS

Journal of the Medical Library Association : JMLA 20200401 2

<h4>Objective</h4>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.<h4>Methods</h4>A randomized controlled trial was conducted with stud ...[more]

PMID: 32256230

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Project description:BackgroundThe evidence base for quality improvement (QI) interventions is expanding rapidly. The diversity of the initiatives and the inconsistency in labeling these as QI interventions makes it challenging for researchers, policymakers, and QI practitioners to access the literature systematically and to identify relevant publications.MethodsWe evaluated search strategies developed for MEDLINE (Ovid) and PubMed based on free text words, Medical subject headings (MeSH), QI intervention components, continuous quality improvement (CQI) methods, and combinations of the strategies. Three sets of pertinent QI intervention publications were used for validation. Two independent expert reviewers screened publications for relevance. We compared the yield, recall rate, and precision of the search strategies for the identification of QI publications and for a subset of empirical studies on effects of QI interventions.ResultsThe search yields ranged from 2,221 to 216,167 publications. Mean recall rates for reference publications ranged from 5% to 53% for strategies with yields of 50,000 publications or fewer. The 'best case' strategy, a simple text word search with high face validity ('quality' AND 'improv*' AND 'intervention*') identified 44%, 24%, and 62% of influential intervention articles selected by Agency for Healthcare Research and Quality (AHRQ) experts, a set of exemplar articles provided by members of the Standards for Quality Improvement Reporting Excellence (SQUIRE) group, and a sample from the Cochrane Effective Practice and Organization of Care Group (EPOC) register of studies, respectively. We applied the search strategy to a PubMed search for articles published in 10 pertinent journals in a three-year period which retrieved 183 publications. Among these, 67% were deemed relevant to QI by at least one of two independent raters. Forty percent were classified as empirical studies reporting on a QI intervention.ConclusionsThe presented search terms and operating characteristics can be used to guide the identification of QI intervention publications. Even with extensive iterative development, we achieved only moderate recall rates of reference publications. Consensus development on QI reporting and initiatives to develop QI-relevant MeSH terms are urgently needed.

Project description:BACKGROUND: Database searching is the most frequently used approach for automated peptide assignment and protein inference of tandem mass spectra. The results, however, depend on the sequences in target databases and on search algorithms. Recently by using an alternative splicing database, we identified more proteins than with the annotated proteins in Aspergillus flavus. In this study, we aimed at finding a greater number of eligible splice variants based on newly available transcript sequences and the latest genome annotation. The improved database was then used to compare four search algorithms: Mascot, OMSSA, X! Tandem, and InsPecT. RESULTS: The updated alternative splicing database predicted 15833 putative protein variants, 61% more than the previous results. There was transcript evidence for 50% of the updated genes compared to the previous 35% coverage. Database searches were conducted using the same set of spectral data, search parameters, and protein database but with different algorithms. The false discovery rates of the peptide-spectrum matches were estimated < 2%. The numbers of the total identified proteins varied from 765 to 867 between algorithms. Whereas 42% (1651/3891) of peptide assignments were unanimous, the comparison showed that 51% (568/1114) of the RefSeq proteins and 15% (11/72) of the putative splice variants were inferred by all algorithms. 12 plausible isoforms were discovered by focusing on the consensus peptides which were detected by at least three different algorithms. The analysis found different conserved domains in two putative isoforms of UDP-galactose 4-epimerase. CONCLUSIONS: We were able to detect dozens of new peptides using the improved alternative splicing database with the recently updated annotation of the A. flavus genome. Unlike the identifications of the peptides and the RefSeq proteins, large variations existed between the putative splice variants identified by different algorithms. 12 candidates of putative isoforms were reported based on the consensus peptide-spectrum matches. This suggests that applications of multiple search engines effectively reduced the possible false positive results and validated the protein identifications from tandem mass spectra using an alternative splicing database.

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Dataset Information

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.

Publications

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.

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