Inquiry in Healthcare

Question: Discuss about theInquiry in Healthcare. Answer: Introduction: Clinicians are challenged continuously for keeping up with the rapidly changing and growing information base that is relevant to their practice areas. Apart from locating the relevant information, they are also expected to assess its quality that should thoroughly investigate their validity. They are also required to deal with the conflicting information by using the different types of sources that include journals, textbooks, systematic reviews and meta-analysis. This essay will answer a research question using the PICO framework based on the principle of the search process and refinement, comparing cranberry juice to the antibiotics for the treatment of urinary tract infection. The research question for this assignment has been presented below. In adult females who suffer frequent urinary tract infections is cranberry juice compared to antibiotics more effective in preventing urinary tract infection? Search Terms The search terms used for this assignment are the therapeutic efficacy of cranberry juice in UTI, antibiotics and cranberry juice comparative efficacy in UTI, adult female UTI prevention or treatment and treatment outcome of urinary tract infection with cranberry. Based on the PICO framework, the search terms were organized and selected to answer the research question. The Boolean terms used were AND and OR. Sources of Information The sources of information used for this study are Pubmed and Embase. Pubmed is free to access search engine used to search the abstracts and references on the biomedical and life sciences topics. It is primarily used to access the Medline database and the rationale for selecting Pubmed is that it is an intuitive and fast search interface and it helps in automatic term mapping by automatic inclusion of medical subject headings and synonyms in the search criteria. Embase is a pharmacological and biomedical database consisting of published literature. The rationale for selecting Embase is the fact that it is used for quicker access to the articles that are newly published. This makes the retrieval from Embase much more comprehensive and the recently published articles are more readily extracted. Therefore, these two sources of information were used as sources of information. Search Process The search process involved searching of the databases using the search terms for answering the research question based on the PICO format. The period of search was refined from 2010 to 2016 and the various parameters were set according to the relevance of the search criteria. The filters and limiters were set accordingly with respect to the PICO framework search criteria and the search parameters have been presented in the table below. Table 1: Search Process and Refinement Actions Search Mode Results Limiters Database: Pubmed Article: Recurrent urinary tract infection in females is a benign disease Author: Wuorela et al. (2016) Heading and Abstract, Boolean used: UTI OR Urinary Tract Infection, Search Term: Adult female UTI prevention or treatment 25191000 items in Pubmed and 3920 items in Embase Filter applied for last six years and sorted by most recent / relevance Database: Pubmed Article: Cranberries for preventing urinary tract infections Author: Jepson, Williams Craig (2012) Heading and Abstract, Boolean used: UTI OR Urinary Tract Infection, Search Term: Therapeutic efficacy of cranberry juice in UTI 6 items in Pubmed and 10 items in Embase Filter applied for last six years and sorted by most recent / relevance Database: Embase Article: Cranberries vs antibiotics to prevent urinary tract infections: a randomized double-blind non inferiority trial in premenopausal women Author: Beerepoot et al. (2011) Heading and Abstract, Boolean used: UTI OR Urinary Tract Infection. Search details: (Antibiotics and cranberry juice) AND (comparative efficacy in UTI) OR (Urinary Tract Infection), Search Term: Antibiotics and cranberry juice comparative efficacy in UTI 32 items in Pubmed and 18 items in Embase Filter applied for last six years and sorted by most recent / relevance Database: Embase Article: Cranberry juice fails to prevent recurrent urinary tract infection: results from a randomized placebo-controlled trial Author: Barbosa-Cesnik et al. (2011) Article: Recurrent urinary tract infection and urinary Escherichia coli in women ingesting cranberry juice daily: a randomized controlled trial Author: Stapleton et al. (2012) Heading and Abstract, Boolean used: Treatment outcome AND Urinary Tract Infection, Search Term: Treatment outcome of urinary tract infection with cranberry 24 items in Pubmed and 268 items in Embase Filter applied for last six years and sorted by most recent / relevance Source: (Richardson-Tench, Taylor, Kermode Roberts, 2016) In few of the cases, the search terms did not yield the satisfactory results. There, the terms were altered in various combinations with different Boolean terms and displacing them with the help of parenthesis. However, the search terms were altered, but the meaning was kept the same to get the best possible and relevant results. Best Evidence The relevance and credibility of the searched articles were determined by selecting the most relevant article depending on its inclusion criteria. The four articles selected according to the population, intervention, comparison and outcome of the PICO framework has selected to answer the research question. Pubmed and Embase are the two databases used for this assignment as they are the prime search engines for biomedical and life sciences topics. Out of the two databases, Embase was found to be more efficient compared to Pubmed as it provided twice as many citations in comparison to Pubmed and it provided a bigger coverage of the total citations retrieved. Embase provides a comprehensive search of the research articles and yielded more relevant results compared to Pubmed. However, Pubmed provided more results in few cases but more citations do not necessarily mean citations of higher quality (Libguides.fiu.edu, 2016). Therefore, Embase was the database of choice for searching the res earch articles. Conclusion From the searched articles, it can be said that cranberry juice is lesser effective in comparison with antibiotics in the prevention of urinary tract infection. The first article studied the population and dealt with the patients of UTI and the consequences of the disease. The second article studied the intervention and this article dealt with the determination of the effectiveness in prevention of UTI. The third article studied the comparison and this article demonstrated a comparative study between TMP-SMX and cranberry capsules and found the former to be more effective. The fourth and fifth articles studied the outcome and these articles found that Cranberry juice had no significant effect in the treatment of UTI. Following the PICO framework, it was found that cranberry juice has been lesser effective when compared with the standard dosage of antibiotics and therefore, has been lesser effective in the prevention and treatment of the disease. It can be recommended for Yani that sh e should continue her antibiotic regimen for the prevention and treatment of UTI rather than changing over to cranberry juice in her diet regularly. References Barbosa-Cesnik, C., Brown, M. B., Buxton, M., Zhang, L., DeBusscher, J., Foxman, B. (2011). Cranberry juice fails to prevent recurrent urinary tract infection: results from a randomized placebo-controlled trial.Clinical Infectious Diseases,52(1), 23-30. Beerepoot, M. A., ter Riet, G., Nys, S., van der Wal, W. M., de Borgie, C. A., de Reijke, T. M., ... Geerlings, S. E. (2011). Cranberries vs antibiotics to prevent urinary tract infections: a randomized double-blind non inferiority trial in premenopausal women.Archives of internal medicine,171(14), 1270-1278. Jepson, R. G., Williams, G., Craig, J. C. (2012). Cranberries for preventing urinary tract infections.Cochrane Database Syst Rev,10(10). Libguides.fiu.edu. (2016).FIU Libraries: Research: Embase Guide | Gua de Embase: Embase vs. PubMed MEDLINE. [online] Available at: https://libguides.fiu.edu/c.php?g=160191p=1047492 [Accessed 5 Sep. 2016]. Richardson-Tench, M., Taylor, B., Kermode, S., Roberts, K. (2016).Research in nursing: Evidence for best practice. Cengage Learning Australia. Stapleton, A. E., Dziura, J., Hooton, T. M., Cox, M. E., Yarova-Yarovaya, Y., Chen, S., Gupta, K. (2012). Recurrent urinary tract infection and urinary Escherichia coli in women ingesting cranberry juice daily: a randomized controlled trial. InMayo Clinic Proceedings(Vol. 87, No. 2, pp. 143-150). Elsevier. Wuorela, M., Isoaho, H., Arve, S., Lehtonen, A., Viitanen, M. (2016). Recurrent urinary tract infection in females is a benign disease.European Geriatric Medicine,7(2), 127-130.