PART 1: DEVELOPING A FOCUSED QUESTION AND ACQUIRING RELEVANT EVIDENCE 1. Use the following categories to help define your problem and what you are looking at in simple terms PICO: Patient/Problem, Intervention, Comparison, and Outcome. (Remember to use your readings to help you if you are unsure) Patient/Problem: _______________________________________________________________ Intervention: __________________________________________________________________ Comparison: __________________________________________________________________ Outcome: ____________________________________________________________________ 2. Now use these terms from the question above to create your PICO research question so that you have a clear purpose for your search: In (P)_________________________ does (I) ____________________ compared with (C)_____________________ improve/reduce (O) _________________? 3. What type of clinical question do you think this PICO answers? □ Therapeutic □ Aetiology □ Diagnostic □ Prevention □ Prognosis □ Others 4. The table below will help you to think of the other terms that you might also like to look up when searching for evidence to help you answer your question – this is part of basic planning for a research search. We ask you to look up alternative terms because sometimes articles from different countries and health systems call things different names – for example, in Australia we sometimes us the term ‘community nurses’, but in the UK they often talk about ‘district nurses’ – if you only searched under ‘district nurse’ you’d miss all the articles which happened to a different term – you would be missing some of the picture! Population Intervention Comparison (not commonly used in actual database search strategy) Outcome (not commonly used in actual database search strategy) What is your population? Main search term: What other terms might have been used? Alternative search terms: What is your intervention? Main search term: What other terms might have been used? Alternative search terms: What is your comparison? Main search term: What other terms might have been used? Alternative search terms: What is your outcome? Main search term: What other terms might have been used? Alternative search terms: 5. Is there a particular group of people that you want to look at? List here any inclusion criteria you might use to refine your search if you have too many papers: Gender: ______________________________ Age Range: ___________________________ Publication Dates: ______________________ Language: ____________________________ 6. What kind of study do you think would best answer your question? Select here which type of article you might want to access. You can also use these to refine your search if you have a lot of papers. □ Randomized Controlled Trial (RCT) □ Cohort Study □ Qualitative Study □ Economic Evaluation □ Case-control Study/Case Series Systematic Search Strategy Worksheet 7. Now that you have decided on WHAT you will be searching, you need to put down a plan of HOW you will search for your articles. This helps you and others to see how you got your evidence and how you made sure you got the best evidence to help you decide on your clinical action. Using the PICO terms in your table, enter each term in a row (group them together under the PICO categories). The next step is to combine similar terms using ‘OR’ . The final step is to use ‘AND’ to combine your searches for different PICO elements. Key terms: 1 2 3 4 5 6 7 8 9 10 11 12 __ OR___OR___OR___ (combine alternate terms for same topic) 13 __ OR___OR___OR___ (combine alternate terms for same topic) 14 ____AND____ OR = combine alternate terms for the same topic – to get as many potential papers as possible! AND = combine the groups of topics to get papers which cover ALL the terms! PART 2: EVIDENCE OF APPLICATION OF SEARCH STRATEGY (PLAN) IN DATABASE SEARCHES Enter your planned search into two different databases of your choice (such as Medline and CINHAL) using the skills you have learnt in the library session, online library videos, and library workshops. 8. Place the screenshots/screengrabs/digital pictures of your two (2) database searchers here. Please ensure your screenshots provide all steps of your search (see the example in Assessment one templet) and are clear enough to be legible – these must be READABLE!! Database search 1 Add space as needed Database search 2 Add space as needed 9. Select a randomised controlled trial that can help you answer your PICO question and place the abstract here. Please add this as a screenshot, do not retype this yourself. (The abstract must be readable) Add space as needed 10. Choose a qualitative study that is relevant to your PICO from the list of provided articles in Assessment 3 folder and place the abstract here. It is ok if your qualitative study does not exactly match your PICO, but it should be relevant. Please add this as a screenshot, do not retype this yourself. (The abstracts must be readable). Add space as needed PART 3.1 APPRAISAL OF YOUR RANDOMISED CONTROLLED TRIAL (Please consider the word limit for each question, 13 marks ) Assessing the quality of the available evidence has also been a key focus this semester. Use the CASP tool for RCTs below to appraise the quality of your selected RCT. Section A: Are the results of the trial valid? Screening Questions 1. Did the trial address a clearly focused issue? Yes No Can’t tell Justify your answer: (Max 50 words) HINT: An issue can be ‘focused’ In terms of The population studied The intervention given The comparator given The outcomes considered 2. Was the assignment of patients to treatments randomised? (Max 50 Words) Yes No Can’t tell Justify your answer: HINT: Consider How was this carried out? Was the allocation sequence concealed from 3. Were all of the patients who entered the trial properly accounted for at its conclusion? (Max 50 words) Yes No Can’t tell Justify your answer: HINT: Consider Was the trial stopped early? Were patients analysed in the groups to which they were randomised? Detailed questions 4. Were patients, health workers and study personnel ‘blind’ to treatment? (Max 50 words) Yes No Can’t tell Justify your answer: HINT: Think about Patients? Health workers? Study personnel? 5. Were the groups similar at the start of the trial? (Max 50 words) Yes No Can’t tell Justify your answer: HINT: Look at Other factors that might affect the outcome such as age, sex, social class researchers and patients? 6. Aside from the experimental intervention were the groups treated equally? (Max 50 words) Yes No Can’t tell Justify your answer: Section B: What are the results? 7. How large was the treatment effect? (Max 150 words) Justify your answer: HINT: Consider What outcomes were measured? Is the primary outcome clearly specified? What results were found for each outcome? 8. How precise was the estimate of the treatment effect? (Max 100 words) Justify your answer: HINT: Consider What are the confidence limits? Section C: Will the results help locally? 9. Can the results be applied in your context? (or to the local population?) (Max 100 words) Yes No Can’t tell Justify your answer: HINT: Consider whether Do you think that the patients covered by the trial are similar enough to the patients to whom you will apply this?, if not how to they differ? 10. Were all clinically important outcomes considered? (Max 50 words) Yes No Can’t tell Justify your answer: HINT: Consider Is there other information you would like to have seen? If not, does this affect the decision? 11. Are the benefits worth the harms and costs? Yes Can’t tell No (Max 100 words) Justify your answer: HINT: Consider: Even if this is not addressed by the review, what do you think? PART 3.2 APPRAISAL OF YOUR QUALITATIVE ARTICLE (please consider the word limit for each question, 11marks ) Use the CASP Appraisal for Qualitative Research below to decide whether the information presented in your paper is trustworthy and truly reflective of the participant’s voice. SCREENING QUESTIONS 1. Was there a clear statement of the aims? ☐Yes ☐ Can’t tell ☐ No HINT: Consider What was the goal of the research? Why it was thought important? Its relevance Your comment: (max 50 words) 2. Is a qualitative methodology appropriate? ☐Yes ☐ Can’t tell ☐ No HINT: Consider If the research seeks to interpret or illuminate the actions and/or subjective experiences of research participants Is qualitative research the right methodology for addressing the research goal? Your comment: (max 50 words) DETAILED QUESTIONS 3. Was the research design appropriate to address the aims of the research? ☐Yes ☐ Can’t tell ☐ No HINT: Consider If the researcher has justified the research design (e.g. have they discussed how they decided which method to use)? Your comment: (max 50 words) 4. Was the recruitment strategy appropriate to the aims of the research? ☐Yes ☐ Can’t tell ☐ No HINT: Consider If the researcher has explained how the participants were selected If they explained why the participants they selected were the most appropriate to provide access to the type of knowledge sought by the study If there are any discussions around recruitment (e.g. why some people chose not to take part) Your comment: (max 100 words) 5. Was the data collected in a way that addressed the research issue? ☐Yes ☐ Can’t tell ☐ No HINT: Consider If the setting for data collection was justified If it is clear how data were collected (e.g. focus group, semi-structured interview etc.) If the researcher has justified the methods chosen If the researcher has made the methods explicit (e.g. for interview method, is there an indication of how interviews were conducted, or did they use a topic guide)? If methods were modified during the study. If so, has the researcher explained how and why? If the form of data is clear (e.g. tape recordings, video material, notes etc) If the researcher has discussed saturation of data Your comment: (Max 100 words) 6. Has the relationship between researcher and participants been adequately considered ☐Yes ☐ Can’t tell ☐ No HINT: Consider If the researcher critically examined their own role, potential bias and influence during a)Formulation of the research questions b)Data collection, including sample recruitment and choice of location How the researcher responded to events during the study and whether they considered the implications of any changes in the research design our comment: (max 50 words) 7. Have ethical issues been taken into consideration? ☐Yes ☐ Can’t tell ☐ No HINT: Consider If there are sufficient details of how the research was explained to participants for the reader to assess whether ethical standards were maintained If the researcher has discussed issues raised by the study (e.g. issues around informed consent or confidentiality or how they have handled the effects of the study on the participants during and after the study) If approval has been sought from the ethics committee Your comment: (Max 50 words) 8. Was the data analysis sufficiently rigorous? ☐Yes ☐ Can’t tell ☐ No HINT: Consider If there is an in-depth description of the analysis process If thematic analysis is used. If so, is it clear how the categories/themes were derived from the data? Whether the researcher explains how the data presented were selected from the original sample to demonstrate the analysis process If sufficient data are presented to support the findings To what extent contradictory data are taken into account Whether the researcher critically examined their own role, potential bias and influence during analysis and selection of data for presentation Your comment: (max 100 words) 9. Is there a clear statement of findings? ☐Yes ☐ Can’t tell ☐ No HINT: Consider whether If the findings are explicit If there is adequate discussion of the evidence both for and against the researchers arguments If the researcher has discussed the credibility of their findings (e.g. triangulation, respondent validation, more than one analyst) If the findings are discussed in relation to the original research question Your comment: (max 100 words) 10. How valuable is the research? (max 100 words) HINT: Consider If the researcher discusses the contribution the study makes to existing knowledge or understanding e.g. do they consider the findings in relation to current practice or policy?, or relevant research-based literature? If they identify new areas where research is necessary If the researchers have discussed whether or how the findings can be transferred to other populations or considered other ways the research may be used Your comment: PART 4.1 OVERALL SUMMARY (400 words, 11 marks ) 11. Provide an overall summary of what these two papers contribute to answering your research question. HINT: Consider What was your original clinical question? What information do you think is useful from these two articles? Do you think the information in the articles is unbiased? If the information from the articles helpful in answering your overall question? PART 4.2 SYNTHESISING THE EVIDENCE (300 words, 5 marks ) Finally, you need to summarise the evidence that relates to your clinical questions in plain language as if you were explaining the rationale for your clinical decision making to a patient within your care.
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