PICO Analysis

Question: Describe the Process you Used for Developing the PICO question? Answer: Introduction Immunization is one the most beneficial aspect of present medical advancement, which offers protection against life-threatening infection. The content of vaccines was derived from either live or dead attenuated pathogenic particles that trigger the immunological reactions in physiology. Often in society there present stereotypes and myths related to use of vaccine and immunization process. In the present scenario, parents are shown to have fear in conjunction with the development of side effects with MMR vaccine. Neurodegenerative development such as the risk of development of Autism in children is one of the common myth present in society. PCIO question The PICO question framed is, Does immunization with MMR vaccine in children, compared to non-immunized children, the present the risk of development of Autism? Population Children having immunization with MMR Intervention Immunization against measles with MMR vaccine Comparator Children with no immunization measures Outcome Probability or risk associated with development of Autism as side effect Thus, the objective of PICO analysis is to find evidence in conjunction with immunization in children with MMR vaccine. The evidence will be helpful in explaining parents regarding the myths and stereotypes associated with the usage of MMR vaccine. On the other hand, collection of evidence in the same regard is also useful to promote the immunization process. Promoting the benefit associated with vaccination and removing the misconceptions with eh help of evidences can thus helpful in controlling infection as well as facilitate healthy state in the community. Search for evidence In general the use of vaccine induces particular series of alteration in the physiological system, which accompanies certain mild to moderate symptoms (Hilton, Petticrew Hunt, 2007). The temporary side effects are present in the form of chills, fever, nausea, vomiting, and gastrointestinal upset. Conversely, there is the certain higher degree of stereotypes present in the society, which prevents the immunization among children. The situation is deleterious as it presents a risk of developing life-threatening risk in children. The searches for the evidence were made using the literature database containing peer-reviewed articles from scientific journals. Ordering of the references was made on the basis of self-judgment for the weakest to strongest point with reference to the PICO question. The specificity of consideration adopted while conducting literature search is to collection information that support the health beneficial aspect of vaccination. As discussed in the above section, the retracted report by Wakefield helps people in making their myth perception more robust, thus effort were given in search the literature that support its negativity. Literature explaining the beneficial aspect of vaccination and evidence that MMR vaccine is not responsible for any development retarding side effects were given preference. Hence, search literature in the same conjunction represents the sensitivity of the analysis. There exists a common stereotype notation among the parents that vaccination may harm the health and development aspect of children. Owing to this notation, often people neglect or having opposing views to for vaccination (Demicheli, Jefferson, Rivetti, Price, 2005). Interestingly, during the literature search one retracted article by Wakefield et al., 1998 was found that is linked with the generalization of MMR side effects in children (Wakefield, 1998 [retracted]). The paper is believed to be important as it correlates with the negative notation and factors corresponding to Autism development in children with MMR vaccine. Hence, other related articles were retrieved from the database to cross-refer the information that forms integral part of this report. The papers obtained were analyzed thoroughly for finding false positive and true negative information in conjunction to the framed PICO question as represented in Table 1. Types of evidence According to the retrieved paper, it was found that the authors have reported links between the gastrointestinal problems with vaccination among children. MMR vaccine is responsible for generating colitis and ileal lymphoid nodular hyperplasia among children, which give rise to several other complications. The gastrointestinal problems on the children health is more significant as it lead to impede the neuronal development relating to verbal, societal interacting phenomenon and non-verbal communication (Wakefield, 1998 [retracted]). Likewise, it is also reported that MMR vaccines have potential to induce inflammatory bowel syndrome among children that cause retardation of normal children growth (Wakefield, 1998 [retracted]). For the neuronal impairment part, the process of immunization is responsible for triggering stressor protein that potentially damage brain parts. The report by Wakefield is published in one of the reputed medical journal The Lancet which put significant impact ov er the community, as many researchers and public health workers implemented changes in care practice based on such report. Furthermore, it put impact over people with the help of generation of myths and stereotypes for vaccine usage. Based on this information, it is common not only for the population, but also for the scientific community to rethink the issue of immunization. Furthermore, the reason is sufficient to offer several stereotypes and myths in the community, which present immunization among children. Based on such information it is believed that the relevance of the PICO question framed is clearly represented. In other reports, it was found that the facts and reports presented the said paper by Wakefield is false and does not have any correlation with the real experimental results (Baird, 2008). Evidence in this regard were prepared by National Health Service of UK, Cochrane Library and Centers for Disease Control and Prevention, US National Academy of Science, which reveals that use of MMR vaccine is free from such side effects (Demicheli, 2005). Furthermore, there is no support regarding the role of MMR vaccine in developing any gastrointestinal side effects and neurodegenerative side effects (Doja Roberts, 2006; Mrozek-Budzyn, 2010). Apart from risk for development of Autism, MMR vaccine is also not responsible to support development of infection related to Crohns disease (Hilton, Petticrew Hunt, 2007), or any form of bacterial and viral infection (Speers Lewis, 2004). Hence, the fact that MMR vaccine is responsible for the development of Autism in children is false and has no link w ith vaccination. Conclusion Based on the evidence of various literatures, the editor of The Lancet, decided to retrieve the article from the journal in the year 2010. The impact of the report on the health beliefs and stereotypes for vaccination are present in society (Greenfield, 2010). The factor responsible for the same is being false scientific publication. Importantly, with the help of PICO analysis, it becomes evident that MMR vaccination has no risk of developing Autism among children. Table 1: List of reference and ranking from the order of strongest to weakest evidence in relation to PICO question. Evidence Authors (year) Order (strongest to weakest) Lack of association between measles-mumps-rubella vaccination and autism in children: A case-control study. Mrozek-Budzyn et al. 2010 Parents' champions vs. vested interests: who do parents believe about MMR? A qualitative study. Hilton et al. 2007 Immunizations and autism: a review of the literature. Doja et al. 2006 Vaccines for measles, mumps, and rubella in children Demicheli et al. 2005 Journalists and jabs: Media coverage of the MMR vaccine Speers et al. 2004 References Baird, G., Pickles, A., Simonoff, E., Charman, T., Sullivan, P., Chandler, S., ... Brown, D. (2008). Measles vaccination and antibody response in autism spectrum disorders. Archives of disease in childhood, 93(10), 832-837. DOI: 10.1136/adc.2007.122937 Doja, A., Roberts, W. (2006). Immunizations and autism: a review of the literature. The Canadian Journal of Neurological Sciences, 33(4), 341-346. DOI:10.1017/s031716710000528x Demicheli, V., Jefferson, T., Rivetti, A., Price, D. (2005). Vaccines for measles, mumps, and rubella in children. Cochrane Database Syst Rev, 4. DOI: 10.1002/14651858.CD004407.pub2 Greenfield, K. T. (2010). The Autism Debate: Whos Afraid of Jenny McCarthy?. Retrieved from https://www.ageofautism.com/2010/02/karl-taro-greenfeld-in-time-the-autism-debate-whos-afraid-of-jenny-mccarthy.html Hilton, S., Petticrew, M., Hunt, K. (2007). Parents' champions vs. vested interests: who do parents believe about MMR? A qualitative study. BMC Public Health, 7(1), 42. DOI:10.1186/1471-2458-7-42 Mrozek-Budzyn, D., Kieltyka, A., Majewska, R. (2010). Lack of association between measles-mumps-rubella vaccination and autism in children: A case-control study. The Pediatric infectious disease journal, 29(5), 397-400. DOI: 10.1097/INF.0b013e3181c40a8a Speers, T., Lewis, J. (2004). Journalists and jabs: Media coverage of the MMR vaccine. Communication medicine, 1(2), 171-181. DOI:10.1515/come.2004.1.2.171 Wakefield, A.J., Murch, S.H., Anthony, A., Linnel, J., Casson, D.M., Malik, M., Berelowitz, M., Dhillon, A.P., Thomson, M.A., Harvey, P., Valentine, A., Davies, S.E., Walker-Smith, J.A. (1998)."Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children". The Lancet. 351(9103): 63741.doi:10.1016/S0140-6736(97)11096-0.PMID9500320.(Retracted). DOI: 10.1016/S0140-6736(10)60175-4