[MUSIC] Hi this is Kay Dickersin and its good to see you again. In this lecture we'll be covering framing the question that your going to address in your systematic review. This is a very important topic because if we get the question right, everything else will follow. We're going to start with section A, and talk about resources that you can use when you're trying to decide how to frame your question. You'll work as a group to frame your question and it will take you at least one session to get it right, maybe more. But there are resources you can use. That is books and other resources to help you along the way. Let's look again at the steps of the systematic review that we talked about last time. Our very first thing that we need to do, after we form our group, is frame the research question we're going to address. And I'll talk about how that's described as PICO, P-I-C-O, or P-E-C-O, depending on whether you're looking at an intervention question. Usually a clinical Type intervention, but it could be behavioral or an ideology question such as we would look at in epidemiology.. Some of the resources that you can access follow, the first is this book. You can also get it for free online called, Finding What Works in Healthcare. It came out in about 2010. And it's put out by the Institute of Medicine. And it's what's called standards for doing a systematic review. Here's an example of the second sample which is initiating a systematic review. In this standard, and I'm not going to go through all the details that's on this slide. You can either read the book which is online for free. You can download it or you could purchase it. A few copies are in the bookstore and we have a copy on reserve in the library. The first step is, establish your team, which is what we are doing right now. The second is to manage the bias and the conflict of interest within your team. And ensure that you have stakeholder input. Who are the important people who might have input into the issues that you're discussing? It might be an environmental epidemiologist, if you're looking at that type of question. Or it might be a clinician. It would probably definitely include a consumer or a patient. And then you have to decide what to do about managing that bias and conflict of interest. If people do have a potential conflict of interest, then you need to ask about it. How do you actually manage it from those who are providing the input? And then finally you would get to what I'm going to talk about today. Which is formulating the topic or framing the question. In the IOM book on how to do a systematic review there's a little more detail on formulating the topic. This includes confirming that you need a new review and that one hasn't already been done very recently. Either done recently or updated and therefore you don't need to do a new one. You need to develop an analytic framework if you're going to do that. And we'll talk about that briefly at the end of this lecture. It's an optional part of our course. But it is one of the IOM standards. aYou need to use a standard format to articulate each question. And we will spend quite a bit of time on how to use the PICO format to articulate your question. State your rationale for each question, and then go back and forth and refine it. And that's when you'll see, working with your group, just how long it takes to come to a final question that you are going to address. And to be honest, this is something we work on throughout the class with the small groups. Because once you find literature, you will see some refinement is probably needed. Another resource for refining your question or framing your question, is the Cochrane handbook For Systematic Reviews of Interventions. Again, you can get this for free online, or you can purchase a hardcopy of the book. I have to confess, I like books, and so I have purchased one. You can get them at the bookstore, we have some copies for sale there. Or you can get it at the library on reserve. Or you can download it chapter by chapter, the way it shows here. Browse the handbook online. And you can go in chapter by chapter, depending on what you need. So, let's say you decide to look at the handbook. This is version 1.1 which, I just checked, is the latest version that's up online. It's from 2011. And defining the review question is found in chapter five. And you can see there separate sections under it for how to define the question and the eligibility criteria. What type of participants will you have, what type of interventions will you have and so forth. And we'll go through all of these topics in a little more detail. But I am just showing you here about the resource that you can use. If you want to go back to the Cochrane handbook to look to see about framing your question. You do not need to use both of these sources. It's just, if you've chosen one to be your major resource for this class. Here's where you find the information you need. And then finally in chapter five, there are some criteria and key points. That you might want to take into consideration when your defining your question that your asking with framing it. So for example, I'm not going to go through this in a lot of detail. You start in the key points with a well framed question. You need to specify the PICO. And with a Cochrane handbook, there's a focus on interventions. But in this class, we're also focusing on etiology, or environmental, in born characteristics of people. So that would be peco, as in P-E-C-O. There is a focus within the Cochrane views on outcomes, and we're going to spend some time on outcomes in this class. Because this is an emerging area in systematic reviews and you'll hear us talk about it a lot more. Than maybe we have in past years because people have realized just how important a well-defined outcome is. So that's it for section A, talking about resources you'll use for framing your question. Our next section will be section B, where we decide the type and scope of our question.