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Nursing and Allied Health: PICO Slides

Learn more about how to use library resources to search for clinical information.

 

Box 1

Evidence Based Medicine:
Information and resources about using EBM in patient care.

The first step of the nursing research process or evidence-based research process involves formulating the clinical question into a searchable, answerable question.  "PICO" is a memonic for this part of the process.

PICO Chart:  Example One
Patient / Population Intervention Comparison Outcome
Who is your patient? What do you plan on doing for the patient? What alternatives are you considering? What do you wish to accomplish
  • Age, sex, race or patient population
  • Primary problem
  • Health status
  • Diagnostic test(s)
  • Medication(s)
  • Procedure(s)
  • Another test, medication or procedure
  • Watchful waiting
  • Accurate diagnosis
  • Relieve or improve symptoms
  • Maintain function

 

PICO Chart: Example Two
Patient / Population Intervention Comparison Outcome
  • Adult
  • History of heart disease
Mediterranean diet
  • Typical Diet
  • No comparison
Reduction in heart attacks

 

 

Evidence Based Medicine:

Information and resources about using EBM in patient care.

Using a structured question frame:

Using a structured question frame can help you clearly define the concepts or variables that make up the specific research question.  PICO(T) is the most common question frame used in health sciences research, where the question is composed of the:

  • Population/Problem/Patient
    • What is the problem to be addressed? What are the characteristics of the patient population, or disease of interest?  
    • Think of this element as the dependent variable
  • Intervention
    • What is the relevant treatment or exposure? What action or change would affect the patient/problem/population?
    • Think of this element as the independent variable
  • Comparison
    • What is the alternative to the intervention? (A different intervention? The usual standard of care? Not intervening at all?)
    • Think of this element like a "control group"
  • Outcome 
    • What are the relevant effects? 
    • Think of this element as what is measured to show what the intervention has accomplished or improved
  • Timeframe or Type of Study (Optional)
    • Think of this element as additional, optional constraints to narrow the question
      • In what time frame should the intervention achieve the outcome?
      • What type of study would best address the PICO question?

For example:

"For adolescents with type II diabetes (P) does the use of telehealth consultations (I) compared to in-person consultations (C) improve blood sugar control (O)?

 

Framing different types of clinical questions:

Framing Different Types of Clinical Questions

Different types of clinical questions are suited to different syntaxes and phrasings, but all will clearly define the PICO elements.  The definitions and frames below may be helpful for organizing your question:

Intervention/Therapy

Questions addressing how a clinical issue, illness, or disability is treated.

"In__________________(P), how does__________________(I) compared to_________________(C) affect______________(O)?"

Etiology

Questions that address the causes or origin of disease, the factors which produce or predispose toward a certain disease or disorder.

"Are_________________(P), who have_________________(I) compared with those without_________________(C) at_________________risk for/of_________________(O) over_________________(T)?" 

Diagnosis:

Questions addressing the act or process of identifying or determining the nature and cause of a disease or injury through evaluation.

In_________________(P) are/is_________________(I) compared with_________________(C) more accurate in diagnosing_________________(O)?

Prognosis/Prediction:

Questions addressing the prediction of the course of a disease.

In_________________(P), how does_________________(I) compared to_________________ (C) influence_________________(O)?

Meaning

Questions addressing how one experiences a phenomenon or why we need to approach practice differently.

"How do_________________(P) with_________________(I) perceive_________________(O)?" 


Adapted from: Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

 

Collect general background information from an authoritative source (also called legitimate source)

 

Background Search: Before we begin our online search, investigate relevant terms in a medical dictionary.  This is preliminary to using Medical Subject Headings.

  • Medical encyclopedias:  GALE GVRL (online), WebMD, Dorland's Medical Encyclopedia (Shreveport), Tabor's Medical Encyclopedia (Shreveport), Mayo Clinic website or other nursing textbooks on your subject in the library stacks are considered authoritative medical information about your subject.
  • Fill in a PICO chart with possible keyword terms. 

This is what a P-I-C-O chart looks like.  Ask your librarian or instructor if you need help getting started.

 

Planning, organizing and deciding what information is needed.

(Adapted from Melnyk, B. M., & Fineout-Overholt, E. (2005). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia, PA: Lippincott Williams & Wilkins.) 2nd edition - 2011

 

4 slides

PowerPoint Slide Presentation

  • stress*   retrieves stress, distress, distressed
  • anxiet*   retrieves anxiety, anxieties

 

 

 

P.I.C.O.(T.) Tips

 

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