Enhancing your practice through evidence-based decision making: PICO, learning how to ask good questions

Miller, Syrene A.; Forrest, Jane L.

doi:10.1067/med.2001.118720

Cited by 41 publications

(32 citation statements)

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“…The PICO is one of the most widely used models of formulating and structuring clinical questions in connection with evidence syntheses. The Cochrane Handbook for Systematic Reviews specifies using PICO as a model for developing a review question, thus ensuring that the relevant components of the question are well defined . The protocol of the current study has been registered in PROSPERO with the identification number of CRD42019122272.…”

Section: Methodsmentioning

confidence: 99%

Dietary acid load, blood pressure, fasting blood sugar and biomarkers of insulin resistance among adults: Findings from an updated systematic review and meta‐analysis

Dehghan

Farhangi

2020

Int J Clin Pract

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Objectives There is no clear summarised report of the association between dietary acid load components including potential renal acid load (PRAL) and net‐endogenous acid production (NEAP) with cardiometabolic risk factors. In the current meta‐analysis, we aimed to systematically review and summarise the eligible observational studies evaluating the association between PRAL and NEAP with blood pressure and hypertension and markers of glucose haemostasis among adults. Design and Setting In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases up to May 2019, relevant studies were included in the literature review. Observational studies evaluating the association between PRAL and NEAP with the systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose, insulin, homeostatic model assessment of insulin resistance (HOMA‐IR), haemoglobin A1C (HbA1C), HOMA‐β and quantitative insulin check index (QUICKI) and also prevalence or odds of hypertension, hyperglycaemia and diabetes were included. Results Total number of studies included in the 14 separate meta‐analyses were as follows: Mean (SD) of SBP (PRAL, n = 12; NEAP, n = 6), mean (SD) of DBP (PRAL, n = 8; NEAP, n = 3), mean (SD) of FBS (PRAL, n = 12; NEAP, n = 5), mean (SD) of HbA1C (PRAL, n = 6; NEAP, n = 4), mean (SD) of HOMA‐IR (PRAL, n = 7), mean (SD) of insulin (PRAL, n = 7; NEAP, n = 2); OR of type 2 diabetes mellitus (T2DM) (PRAL, n = 8; NEAP; n = 6), HTN prevalence (PRAL, n = 9; NEAP, n = 9), T2DM prevalence (PRAL, n = 7; NEAP, n = 6). According to our results, being in the highest PRAL categories was associated with higher SBP (WMD = 0.98; CI: 0.51, 1.45; P < .001), DBP (WMD = 0.61; CI: 0.089, 1.135; P = .022), insulin (WMD = −0.235, CI: 0.070, 0.400; P = .005), higher odds of diabetes (OR = 1.19; CI: 1.092, 1.311; P < .001), higher prevalence of T2DM (13% and 11% in highest vs lowest category). While, being in the highest category of NEAP was only associated with higher odds of diabetes (OR = 1.22; CI: 1.14, 1.31, P < .001). In subgroup analysis for finding the possible source of heterogeneity, the continent, dietary assessment tool, sample size and gender were the potent sources of heterogeneity. No association between PRAL and NEAP with HbA1C, HOMA‐IR was reported. Conclusions In the current meta‐analysis, we found potent negative effects of high dietary acid load particularly higher PRAL scores cardiometabolic risk factors. Therefore, lower acidogenic food ingredients in the diets are suggested for the prevention of cardiovascular risk factors and diabetes.

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Section: Methodsmentioning

confidence: 99%

Dietary acid load, blood pressure, fasting blood sugar and biomarkers of insulin resistance among adults: Findings from an updated systematic review and meta‐analysis

Dehghan

Farhangi

2020

Int J Clin Pract

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“…PICOS (Participants, Interventions, Comparators, Outcomes, and Study design) guidelines [35] were used to establish specific inclusion/exclusion criteria. To be included, articles must have: a) had participants diagnosed with diabetes, b) assessed an intervention designed to promote well-being (rather than aiming to reduce a negative construct), and c) used a prospective study design.…”

Section: Methodsmentioning

confidence: 99%

Well-being interventions for individuals with diabetes: A systematic review

Massey

Feig

Duque-Serrano

et al. 2019

Diabetes Research and Clinical Practice

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In patients with diabetes, psychological well-being constructs (e.g., optimism, positive affect) have been associated with superior medical outcomes, including better glucose control and lower mortality rates. Well-being interventions may be well-suited to individuals with diabetes, as they are simple to deliver, broadly applicable across a range of psychological distress, and may help increase self-efficacy and motivation for diabetes self-care. This systematic review, completed using PRISMA guidelines, examined peer-reviewed studies indexed in PubMed, PsycINFO, and/or Scopus between database inception and October 2017 that investigated the effects of well-being interventions (e.g., positive psychology interventions, mindfulness-based interventions, resilience-based interventions) on psychological and physical health outcomes in individuals with Type 1 or Type 2 diabetes. The search yielded 34 articles (N=1635 participants), with substantial variability in intervention type, measures used, and outcomes studied; the majority found the intervention to provide benefit. Overall, results indicate that a range of well-being interventions appear to have promise in improving health outcomes in this population, but the literature does not yet provide definitive data about which specific interventions are most effective. The variability in interventions and outcomes points to a need for further rigorous, controlled, and well-powered studies of specific interventions, with well-accepted, clinically relevant outcome measures.

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“…Eligible studies were assessed with criteria in line with the PICOS (Participants, Interventions, Comparators, Outcomes, and Study design) search strategy [20]. To be included, studies had to (a) study a cardiac population, with comorbidities permissible as long as cardiac illness was the primary diagnosis, (b) assess effects of positive psychological constructs on health-related cardiac outcomes, such as mortality, rehospitalizations, cardiac events, or health status, and (c) use a prospective, observational study design, such that a baseline measurement of a positive construct was followed by a subsequent measurement of a health outcome at a later timepoint.…”

Section: Methodsmentioning

confidence: 99%

Relationships between positive psychological constructs and health outcomes in patients with cardiovascular disease: A systematic review

DuBois

Lopez

Beale

et al. 2015

International Journal of Cardiology

160

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Depression and anxiety are well-known to be associated with adverse health outcomes in cardiac patients. However, there has been less work synthesizing the effects of positive psychological constructs (e.g., optimism) on health-related outcomes in cardiac patients. We completed a systematic review of prospective observational studies using established guidelines. A search of PubMed and PsycINFO databases from inception to January 2014 was used to identify articles. To be eligible, studies were required to assess effects of a positive psychological construct on subsequent health-related outcomes (including mortality, rehospitalizations, self-reported health status) in patients with established heart disease. Exploratory random effects meta-analyses were performed on the subset of studies examining mortality or rehospitalizations. Seventy-seven analyses from 30 eligible studies (N=14,624) were identified. Among studies with 100 or more participants, 65.0% of all analyses and 64.7% of analyses adjusting for one or more covariates reported a significant (p<.05) association between positive psychological constructs and subsequent health outcomes. An exploratory meta-analysis of 11 studies showed that positive constructs were associated with reduced rates of rehospitalization or mortality in unadjusted (odds ratio=.87; 95% confidence interval [.83, .92]; p<.001) and adjusted analyses (odds ratio=.89; 95% confidence interval [.84, .91]; p<.001); there was little suggestion of publication bias. Among cardiac patients, positive psychological constructs appear to be prospectively associated with health outcomes in most but not all studies. Additional work is needed to identify which constructs are most important to cardiac health, and whether interventions can cultivate positive attributes and improve clinical outcomes.

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Enhancing your practice through evidence-based decision making: PICO, learning how to ask good questions

Cited by 41 publications

References 0 publications

Dietary acid load, blood pressure, fasting blood sugar and biomarkers of insulin resistance among adults: Findings from an updated systematic review and meta‐analysis

Dietary acid load, blood pressure, fasting blood sugar and biomarkers of insulin resistance among adults: Findings from an updated systematic review and meta‐analysis

Well-being interventions for individuals with diabetes: A systematic review

Relationships between positive psychological constructs and health outcomes in patients with cardiovascular disease: A systematic review

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