The 17 Frankfurt Consensus Conference on PBM (2018)34 PICO questions
| PICO questions . |
|---|
| Preoperative anemia |
| PICO 1: Adverse events. In elective surgery patients [population], is preoperative anemia [intervention/risk factor] a risk factor for adverse clinical or economic outcome [outcomes] compared with no preoperative anemia [comparison]? |
| PICO 2: Definition. In elective surgery patients [population], should a specific Hb cutoff [index test] vs another Hb cutoff [comparator test] be used to diagnose preoperative anemia [outcome]? (It was not answered because of lack in evidence) |
| PICO 3: Management. In elective surgery patients with preoperative anemia [population], is the use of RBC transfusion or iron supplementation and/or erythrocyte-stimulating agents [intervention] effective to improve clinical and economic outcomes [outcomes] compared with no intervention/placebo/standard of care [comparison]? |
| RBC concentrate transfusion thresholds |
| PICO 4: Adult intensive care patients. In critically ill but clinically stable adult intensive care patients [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 5: Orthopedic and noncardiac surgery. In elderly high-risk (cardiovascular) patients undergoing orthopedic or noncardiac surgery [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 6: Acute gastrointestinal bleeding. In patients with an acute gastrointestinal bleeding [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 7: Coronary heart disease. In patients with symptomatic coronary heart disease [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 8: Septic shock. In patients with septic shock [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 9: Cardiac surgery. In patients undergoing cardiac surgery [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 10: Adult hematological patients. In adult hematological patients [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 11: Adult patients with solid tumors. In adult patients with solid tumors [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 12: Acute central nervous system injury. In patients with acute central nervous system injury [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 13: Cerebral perfusion disorders. In patients with cerebral perfusion disorders [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 14: Acute bleeding. In patients with acute bleeding [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| Implementation of PBM programs |
| PICO 15: Effectiveness of PBM implementation. Is a PBM program [intervention] effective to improve clinical and economic outcomes [outcomes] compared with no PBM program [comparison]? |
| PICO 16: PBM promotional tools: behavioral interventions. Is a specific behavioral intervention to promote the implementation of a PBM program [intervention] more effective to improve clinical and economic outcomes [outcomes] compared with no/another behavioral intervention [comparison]? |
| PICO 17: PBM promotional tools: decision support systems. Is a specific decision support system to promote the implementation of a PBM program [intervention] more effective to improve clinical and economic outcomes [outcomes] compared with no intervention or another decision support system/behavioral intervention [comparison]? |
| PICO questions . |
|---|
| Preoperative anemia |
| PICO 1: Adverse events. In elective surgery patients [population], is preoperative anemia [intervention/risk factor] a risk factor for adverse clinical or economic outcome [outcomes] compared with no preoperative anemia [comparison]? |
| PICO 2: Definition. In elective surgery patients [population], should a specific Hb cutoff [index test] vs another Hb cutoff [comparator test] be used to diagnose preoperative anemia [outcome]? (It was not answered because of lack in evidence) |
| PICO 3: Management. In elective surgery patients with preoperative anemia [population], is the use of RBC transfusion or iron supplementation and/or erythrocyte-stimulating agents [intervention] effective to improve clinical and economic outcomes [outcomes] compared with no intervention/placebo/standard of care [comparison]? |
| RBC concentrate transfusion thresholds |
| PICO 4: Adult intensive care patients. In critically ill but clinically stable adult intensive care patients [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 5: Orthopedic and noncardiac surgery. In elderly high-risk (cardiovascular) patients undergoing orthopedic or noncardiac surgery [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 6: Acute gastrointestinal bleeding. In patients with an acute gastrointestinal bleeding [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 7: Coronary heart disease. In patients with symptomatic coronary heart disease [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 8: Septic shock. In patients with septic shock [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 9: Cardiac surgery. In patients undergoing cardiac surgery [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 10: Adult hematological patients. In adult hematological patients [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 11: Adult patients with solid tumors. In adult patients with solid tumors [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 12: Acute central nervous system injury. In patients with acute central nervous system injury [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 13: Cerebral perfusion disorders. In patients with cerebral perfusion disorders [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| PICO 14: Acute bleeding. In patients with acute bleeding [population], is the use of a restrictive transfusion threshold [intervention] effective to reduce mortality and improve other clinical outcomes [outcomes] compared with a liberal transfusion threshold [comparison]? |
| Implementation of PBM programs |
| PICO 15: Effectiveness of PBM implementation. Is a PBM program [intervention] effective to improve clinical and economic outcomes [outcomes] compared with no PBM program [comparison]? |
| PICO 16: PBM promotional tools: behavioral interventions. Is a specific behavioral intervention to promote the implementation of a PBM program [intervention] more effective to improve clinical and economic outcomes [outcomes] compared with no/another behavioral intervention [comparison]? |
| PICO 17: PBM promotional tools: decision support systems. Is a specific decision support system to promote the implementation of a PBM program [intervention] more effective to improve clinical and economic outcomes [outcomes] compared with no intervention or another decision support system/behavioral intervention [comparison]? |