The efficacy of nonsurgical treatment
Topic for #1 (Does nonsurgical treatment such as physical therapy a better intervention compared to surgical reconstruction?).
1. please share with the class one topic that you are looking at researching for this course (stated above). Is your topic achievable (does it align with your area or discipline)? Is your topic specific? Is your topic relevant to what we see happening in health care today? Why is this topic of interest to you? Provide detailed feedback to your classmates as you all work to narrow your topic. (200 words).
Discuss the PICO format, why is this format used widely in health care research? Explain what each letter of P-I-C-O defines. Finally, provide a PICO statement for your proposed topic of (Does nonsurgical treatment such as physical therapy a better intervention compared to surgical reconstruction?). (200 words).
The selected topic is the efficacy of nonsurgical treatment options such as physical therapy for patients with primary patellar dislocation. Primary patellar dislocation requires effective treatment to avoid painful instability, subsequent re-dislocations, and patellofemoral degeneration (Rund, Hinckel & Sherman, 2021).
The research topic focuses on the use of nonsurgical treatment as the first-line treatment option. The topic is achievable as it will assess the treatment outcomes in patients undergoing physical therapy versus patients undergoing surgical reconstruction. The topic is also relevant because ineffective treatment of patellar dislocation is associated with residual symptoms of instability and a high re-dislocation rate (Rund, Hinckel & Sherman, 2021). Therefore, it is vital to research the most effective treatment, likely to achieve the best treatment outcomes for patients with primary patellar dislocation. Moreover, the topic is very relevant in healthcare today because the rate of patellar dislocations is relatively higher, especially among younger people (Reijman et al., 2021). Additionally, the high incidence of falls and unintentional accidents had led to a high rate of patellar dislocations and thus the most effective treatment option needs to be researched and identified. Moreover, the treatment of patients who experience dislocation for the first time is controversial (Reijman et al., 2021). Even if both surgical and non-surgical treatment can be selected, there is a scarcity of literature supporting the treatment decisions. This further indicates the significance of researching the selected topic to identify the management decision with the best health outcomes.
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PICO format is a mnemonic for the essential elements of a well-developed clinical question. The PICO format makes the search and retrieval of evidence easier as it helps in formulating the search strategy by identifying the main concepts needed in the journal articles and other sources of evidence to answer the research question (Brown, 2020). Therefore, a PICO format allows a specific and focused search of the literature. Without a well-focused research question, it can be challenging and time-consuming to research for the relevant evidence and retrieve suitable sources of evidence. PICO stands for:
• P (Population or patient problem)
• I (Intervention)
• C (Comparison)
The population includes the patient’s demographics such as gender or age, while the patient problem refers to the type of the health problem such as the type of illness or clinical problem. Intervention includes the treatment being considered such as the specific medication or therapy while the comparison is the comparable treatment options being considered to assess if the intervention has better efficacy when compared to the comparison. The outcome refers to the desired outcome of the proposed intervention (Eriksen & Frandsen, 2018).
In patients with patellar dislocation (P), is nonsurgical treatment such as physical therapy(I) a better intervention (O) compared to surgical reconstruction (C)?
Brown, D. (2020). A review of the PubMed PICO tool: using evidence-based practice in health education. Health promotion practice, 21(4), 496-498.
Eriksen, M. B., & Frandsen, T. F. (2018). The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review. Journal of the Medical Library Association: JMLA, 106(4), 420–431. https://doi.org/10.5195/jmla.2018.345
Rund, J. M., Hinckel, B. B., & Sherman, S. L. (2021). Acute Patellofemoral Dislocation: Controversial Decision-Making. Current reviews in musculoskeletal medicine, 14(1), 82–87. https://doi.org/10.1007/s12178-020-09687-z
Reijman, M., Eggerding, V., van Es, E., van Arkel, E., van den Brand, I., van Linge, J., … & Meuffels, D. (2021). Early surgical reconstruction versus rehabilitation with elective delayed reconstruction for patients with anterior cruciate ligament rupture: COMPARE randomized controlled trial. BMJ, 372.