Another preventative measure OR maybe not applicable. Mortality rate, number of days off work, disease incidence. Diagnosis Specific disease or condition. A diagnostic test or procedure. Current "reference standard" or "gold standard" test for that disease or condition.
Measures of the test utility, i. Prognosis Forecast Duration and severity of main prognostic factor or clinical problem. Usually time or "watchful waiting". Usually not applicable.
Survival rates, mortality rates, rates of disease progression. Etiology Causation Patient's risk factors, current health disorders, or general health condition.
The intervention or exposure of interest. Writing Your Question Statement Once you have clearly identified the main elements of your question using the PICO framework, it is easy to write your question statement. Question Type P atient Problem or Population I ntervention or Exposure C omparison or Control O utcome Measure Therapy In patients with osteoarthritis of the knee is hydrotherapy more effective than traditional physiotherapy in relieving pain? Prevention For obese children does the use of community recreation activities compared to educational programs on lifestyle changes reduce the risk of diabetes mellitus?
Diagnosis For deep vein thrombosis is D-dimer testing or ultrasound more accurate for diagnosis? Prognosis In healthy older women that suffer hip fractures within the year after injury what is the relative risk of death? Etiology Do adults who binge drink compared to those who do not binge drink have higher mortality rates? References 1. Broaden the scope - "The Forest" Provides basics for a a greater grasp of concepts Typically found in textbooks, guidelines, point-of-care monographs, encyclopedias, or topic reviews Have two essential components: Example: What causes migraines?
A question root who, what, when, etc. Focused in scope - "The Trees" Requires a grasp of basic concepts to fully comprehend Typically found in journals and conference proceedings Have 3 or 4 essential components see PICO below. Intervention or cause, prognosis What is the main intervention or therapy you wish to consider?
Comparison optional Is there an alternative treatment to compare? Outcome What is the clinical outcome, including a time horizon if relevant? Example In patients with acute bronchitis, do antibiotics none reduce sputum production, cough or days off?
Example In children with cancer what are the current treatments in the management of fever and infection? Example Among family-members of patients undergoing diagnostic procedures does standard care, listening to tranquil music, or audio taped comedy routines make a difference in the reduction of reported anxiety. Report a problem. Subjects: Evidence-Based Practice , Nursing. S ample size may very in qualitative and quantitative studies.
S etting is the context for the question - where. Search this Guide Search. How do you wish to I ntervene - what do you want to do with this patient - treat, diagnose, observe, etc.? What is the C omparison or alternative to the intervention - placebo, different drug or therapy, surgery, etc.? What are the possible O utcomes - morbidity, death, complications, etc.? To develop an effective search strategy, use the PICO worksheet below. See the completed example worksheet below.
PICO Example. PICO Worksheet. I nterest relates to a defined event, activity, experience or process Co ntext is the setting or distinct characteristics Here is an example of a clinical question that outlines the PICo components: See the completed example worksheet below. PICo Example.
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