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If you have any questions about this material, please contact PHB Continuing Medical Education Office at 803-296-2795.

Tutorial: How to Form an Answerable Clinical Question. If you have any questions about this material, please contact PHB Continuing Medical Education Office at 803-296-2795. Learning Objectives. Identify the model to create a well-built Clinical Question

JasminFlorian
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If you have any questions about this material, please contact PHB Continuing Medical Education Office at 803-296-2795.

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  1. Tutorial: How to Form an Answerable Clinical Question If you have any questions about this material, please contact PHB Continuing Medical Education Office at 803-296-2795.

  2. LearningObjectives • Identify the model to create a well-built Clinical Question • Differentiate between the various Evidence- Based Care Types of Questions / Study Designs • Review Clinical Scenarios

  3. Five steps to Evidence-Based Care (EBC): • ASK = Develop your answerable clinical question • ACQUIRE = Efficiently find the best evidence • APPRAISE = Critically evaluate the evidence for its validity and usefulness • APPLY = Use the results of the appraisal in your clinical practice • ASSESS = Evaluate your performance Sackett DL, Straus SE, et al. Evidence Based Medicine: How to Practice and Teach EBM 2nd Ed. Churchill Livingston: Edinburgh, 2000.

  4. Efficiency is Key • Finding the right information in the most efficient manner is key to successfully practicing evidence-based decision making. • Knowing what key components to use in your search strategy will help you develop that efficiency. • These key components of interest are: - Patient/Population - Intervention/Exposure - Comparison - Outcome

  5. The Well-Built Clinical Question:“PICO” Model • Patient/Population/Problem (among ______) • Intervention/Exposure (does______) • Comparison (versus _______) • Outcome (affect ________)

  6. P=Patient/PopulationofInterest • Who are the patients of interest? • Is there a particular age group, gender or population? • What is the health concern? Example: For persons entering a health care facility….

  7. I=InterventionorExposure • What therapeutic, diagnostic, preventive or other health care interventions are you interested in knowing more about? • What health care management strategies are you interested in comparing? Example: For persons entering a health care facility, is hand rubbing with a waterless, alcohol-based solution…

  8. C=Comparisonof Interest • Is there a comparison to be evaluated against the intervention? • Only used if more than one intervention or if no intervention is a factor. Example: For persons entering a health care facility, is hand rubbing with a waterless, alcohol-based solution, as effective as standard hand washing with antiseptic soap….

  9. O=Outcomeof Interest • What is the desired outcome to be evaluated? • How will the patient or population be affected, or not affected, by the intervention? Example: For persons entering a health care facility, is hand rubbing with a waterless, alcohol-based solution, as effective as standard hand washing with antiseptic soap for reducing hand contamination? Example from: DiCenso A, Guyatt G, Ciliska D. (2005). Evidence-Based Nursing: A Guide to Clinical Practice. St. Louis, MO: Mosby.

  10. In addition to the PICO elements of your clinical question, it’s important to know: What TYPE of question are you asking? What is the best STUDY DESIGN to search for to find evidence to answer your clinical question? So let’s look at how to add these to the PICO model…

  11. P.I.C.O. (T.T.)Modelfor Clinical Questions

  12. What type of question are you asking and what will the evidence support? Crumley, E, Koufoglannakis, D, Stobart, K. Teaching EBP, part 1. Case scenarios and the well-built clinical question. Bibliotheca Medica Canadiana 2000: 22(2): 80-84.

  13. Adapted from: Sackett et al.’s Evidence-Based Medicine: How to Practice and Teach EBM

  14. Limits of PICO (TT) • This model works best for Therapy/Treatment & Diagnosis questions. • Remember, PICO (TT) is a model, not a rigid structure.

  15. In Summary • Finding the right information in the most efficient manner is key to successfully practicing evidence-based decision making. • Using the PICO model to determine your clinical question will help you develop that efficiency. • Knowing what TYPE of clinical question you are asking will help you know what is the best study design to provide evidence to answer your clinical question.

  16. Acknowledgements • With sincere thanks to the members of the CME organization of Cincinnati Children’s Hospital for supplying content for this slide tutorial.

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