Clear and present questions: formulating questions for evidence based practice
TL;DR: This conceptual paper extrapolates findings from healthcare research to general librarianship and models the process of question formulation using a proposed conceptual framework (SPICE) and encourages practitioners to identify their own practice‐based questions.
Abstract: Purpose – The paper seeks to provide an overview and update of thinking in relation to the theory and practice of formulation of answerable research questions within evidence based information practice.Design/methodology/approach – The paper reviews the healthcare and information literature on question formulation, augmented by structured and purposive internet searches.Findings – Although a few key authors have published extensively on all aspects of the evidence‐based information practice process, including question formulation, there is little in the way of empirical research.Research limitations/implications – In the absence of an empirical research base from within the specific domain of information practice, this conceptual paper extrapolates findings from healthcare research to general librarianship.Practical implications – This article models the process of question formulation using a proposed conceptual framework (SPICE) and encourages practitioners to identify their own practice‐based questions...
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University of Toronto1, St. Michael's Hospital2, Northeastern University3, Ottawa Hospital Research Institute4, University of South Australia5, Royal College of Physicians and Surgeons of Canada6, Canadian Agency for Drugs and Technologies in Health7, RAND Corporation8, American University of Beirut9, Agency for Healthcare Research and Quality10, University of Ottawa11, University of York12, University of Alberta13, McMaster University14, South African Medical Research Council15, Queen's University16, Dalhousie University17, World Health Organization18, Cochrane Collaboration19, King's College London20
TL;DR: A PRISMA extension for scoping reviews was needed to provide reporting guidance for this specific type of knowledge synthesis and was developed according to published guidance by the EQUATOR (Enhancing the QUAlity and Transparency of health Research) Network for the development of reporting guidelines.
Abstract: Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.
11,709 citations
TL;DR: The SPIDER tool is used to advance thinking beyond PICO in its suitable application to qualitative and mixed methods research, however, the need for improved indexing of qualitative articles in databases is highlighted.
Abstract: Standardized systematic search strategies facilitate rigor in research. Current search tools focus on retrieval of quantitative research. In this article we address issues relating to using existing search strategy tools, most typically the PICO (Population, Intervention, Comparison, Outcome) formulation for defining key elements of a review question, when searching for qualitative and mixed methods research studies. An alternative search strategy tool for qualitative/mixed methods research is outlined: SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type). We used both the SPIDER and PICO search strategy tools with a qualitative research question. We have used the SPIDER tool to advance thinking beyond PICO in its suitable application to qualitative and mixed methods research. However, we have highlighted once more the need for improved indexing of qualitative articles in databases. To constitute a viable alternative to PICO, SPIDER needs to be refined and tested on a wider range of topics.
959 citations
Cites methods from "Clear and present questions: formul..."
...SPICE was developed in the context of evidence-based librarianship and subsequently promoted by the Joanna Briggs Institute for qualitative systematic reviews (Booth, 2006)....
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TL;DR: A comprehensive literature search was conducted to determine if the use of the patient, intervention, comparison, outcome (PICO) model as a search strategy tool affects the quality of a literature search.
Abstract: Objective: This review aimed to determine if the use of the patient, intervention, comparison, outcome (PICO) model as a search strategy tool affects the quality of a literature search. Methods: A comprehensive literature search was conducted in PubMed, Embase, CINAHL, PsycINFO, Cochrane Library, Web of Science, Library and Information Science Abstracts (LISA), Scopus, and the National Library of Medicine (NLM) catalog up until January 9, 2017. Reference lists were scrutinized, and citation searches were performed on the included studies. The primary outcome was the quality of literature searches and the secondary outcome was time spent on the literature search when the PICO model was used as a search strategy tool, compared to the use of another conceptualizing tool or unguided searching. Results: A total of 2,163 records were identified, and after removal of duplicates and initial screening, 22 full-text articles were assessed. Of these, 19 studies were excluded and 3 studies were included, data were extracted, risk of bias was assessed, and a qualitative analysis was conducted. The included studies compared PICO to the PIC truncation or links to related articles in PubMed, PICOS, and sample, phenomenon of interest, design, evaluation, research type (SPIDER). One study compared PICO to unguided searching. Due to differences in intervention, no quantitative analysis was performed. Conclusions: Only few studies exist that assess the effect of the PICO model vis-a-vis other available models or even vis-a-vis the use of no model. Before implications for current practice can be drawn, well-designed studies are needed to evaluate the role of the tool used to devise a search strategy. This article has been approved for the Medical Library Association’s Independent Reading Program .
393 citations
Cites methods from "Clear and present questions: formul..."
...Despite the existence of other models—such as sample, phenomenon of interest, design, evaluation, research type (SPIDER) [7] and setting, perspective, intervention, comparison, evaluation (SPICE) [8]— the PICO model is by far the most widely used model for formulating clinical questions....
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TL;DR: The effectiveness of healthy eating nudges in field settings increases as they shift from focusing on influencing cognition to affect to behavior.
Abstract: The effectiveness of healthy eating nudges in field settings increases as they shift from focusing on influencing cognition to affect to behavior.
230 citations
TL;DR: If a shared model of the literature searching process can be detected across systematic review guidance documents and, if so, how this process is reported in the guidance and supported by published studies is determined.
Abstract: Systematic literature searching is recognised as a critical component of the systematic review process. It involves a systematic search for studies and aims for a transparent report of study identification, leaving readers clear about what was done to identify studies, and how the findings of the review are situated in the relevant evidence. Information specialists and review teams appear to work from a shared and tacit model of the literature search process. How this tacit model has developed and evolved is unclear, and it has not been explicitly examined before. The purpose of this review is to determine if a shared model of the literature searching process can be detected across systematic review guidance documents and, if so, how this process is reported in the guidance and supported by published studies. A literature review. Two types of literature were reviewed: guidance and published studies. Nine guidance documents were identified, including: The Cochrane and Campbell Handbooks. Published studies were identified through ‘pearl growing’, citation chasing, a search of PubMed using the systematic review methods filter, and the authors’ topic knowledge. The relevant sections within each guidance document were then read and re-read, with the aim of determining key methodological stages. Methodological stages were identified and defined. This data was reviewed to identify agreements and areas of unique guidance between guidance documents. Consensus across multiple guidance documents was used to inform selection of ‘key stages’ in the process of literature searching. Eight key stages were determined relating specifically to literature searching in systematic reviews. They were: who should literature search, aims and purpose of literature searching, preparation, the search strategy, searching databases, supplementary searching, managing references and reporting the search process. Eight key stages to the process of literature searching in systematic reviews were identified. These key stages are consistently reported in the nine guidance documents, suggesting consensus on the key stages of literature searching, and therefore the process of literature searching as a whole, in systematic reviews. Further research to determine the suitability of using the same process of literature searching for all types of systematic review is indicated.
208 citations
Cites methods from "Clear and present questions: formul..."
...Booth provides an overview on formulating questions for evidence based practice [69] and has developed a number of alternatives to the PICO structure, namely: BeHEMoTh (Behaviour of interest; Health context; Exclusions; Models or Theories) for use when systematically identifying theory [55]; SPICE (Setting, Perspective, Intervention, Comparison, Evaluation) for identification of social science and evaluation studies [69] and, working with Cooke and colleagues, SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) [70]....
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22,082 citations
TL;DR: Evidence Based Medicine (IBM) as discussed by the authors is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients, which is a hot topic for clinicians, public health practitioners, purchasers, planners and the public.
Abstract: It's about integrating individual clinical expertise and the best external evidence
Evidence based medicine, whose philosophical origins extend back to mid-19th century Paris and earlier, remains a hot topic for clinicians, public health practitioners, purchasers, planners, and the public. There are now frequent workshops in how to practice and teach it (one sponsored by the BMJ will be held in London on 24 April); undergraduate1 and postgraduate2 training programmes are incorporating it3 (or pondering how to do so); British centres for evidence based practice have been established or planned in adult medicine, child health, surgery, pathology, pharmacotherapy, nursing, general practice, and dentistry; the Cochrane Collaboration and Britain's Centre for Review and Dissemination in York are providing systematic reviews of the effects of health care; new evidence based practice journals are being launched; and it has become a common topic in the lay media. But enthusiasm has been mixed with some negative reaction.4 5 6 Criticism has ranged from evidence based medicine being old hat to it being a dangerous innovation, perpetrated by the arrogant to serve cost cutters and suppress clinical freedom. As evidence based medicine continues to evolve and adapt, now is a useful time to refine the discussion of what it is and what it is not.
Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The …
12,134 citations
01 Apr 1985
TL;DR: In this article, the reflective practitioner how professionals think in action arena, searching the book that you love to read first or find an interesting book that will make you want to read.
Abstract: What do you do to start reading the reflective practitioner how professionals think in action arena ? Searching the book that you love to read first or find an interesting book that will make you want to read? Everybody has difference with their reason of reading a book. Actuary, reading habit must be from earlier. Many people may be love to read, but not a book. It's not fault. Someone will be bored to open the thick book with small words to read. In more, this is the real condition. So do happen probably with this the reflective practitioner how professionals think in action arena .
10,073 citations
"Clear and present questions: formul..." refers background in this paper
...Keywords Evidence-based practice, Librarianship, Research Paper type Conceptual paper...
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...Donald Schon points out that the concept of “reflection” is central to understanding what professionals do (Schön, 1983)....
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TL;DR: In this paper, the crisis of confidence in professional knowledge from technical rationality to reflection-in-action is discussed and its implications for the professions and their place in society are discussed.
Abstract: Contents: Professional Knowledge and Reflection-in-Action: The crisis of confidence in professional knowledge From technical rationality to reflection-in-action. Professional Contexts for Reflection-in-Action: Design as a reflective conversation with the situation Psychotherapy: The patient as a universe of one The structure of reflection-in-action Reflective practice in the science-based professions Town planning: Limits to reflection-in-action The art of managing: Reflection-in-action within an organizational learning system Patterns and limits of reflection-in-action across the professions. Conclusion: Implications for the professions and their place in society.
4,076 citations
TL;DR: An important goal of the medical residency program is to educate physicians in the practice of evidence-based medicine, and strategies include a weekly, formal academic half-day for residents devoted to learning the necessary skills.
Abstract: A NEW paradigm for medical practice is emerging. Evidence-based medicine de-emphasizes intuition, unsystematic clinical experience, and pathophysiologic rationale as sufficient grounds for clinical decision making and stresses the examination of evidence from clinical research. Evidence-based medicine requires new skills of the physician, including efficient literature searching and the application of formal rules of evidence evaluating the clinical literature. An important goal of our medical residency program is to educate physicians in the practice of evidence-based medicine. Strategies include a weekly, formal academic half-day for residents, devoted to learning the necessary skills; recruitment into teaching roles of physicians who practice evidence-based medicine; sharing among faculty of approaches to teaching evidence-based medicine; and providing faculty with feedback on their performance as role models and teachers of evidence-based medicine. The influence of evidencebased medicine on clinical practice and medical education is increasing. CLINICAL SCENARIO A junior medical resident working in a teaching hospital
3,906 citations