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Lesson 4a – Discussion 3165

Homework Answsers / Nursing

The Well-Built Clinical Question

PICO Worksheet

INSTRUCTIONS:

Think about a complex clinical problem that you encountered in your daily practice. Use the following table to identify the patient/population, intervention, comparison, and outcomes. Once is done try to formulate your question.

Question Components

Your Question

P – Patient or Population

Describe the most important characteristics of the patient.

(e.g., age, disease/condition, gender)

I – Intervention; Prognostic Factor; Exposure

Describe the main intervention.

(e.g., drug or other treatment, diagnostic/screening test)

C – Comparison (if appropriate)

Describe the main alternative being considered.

(e.g., placebo, standard therapy, no treatment, the gold standard)

O – Outcome

Describe what you’re trying to accomplish, measure, improve, affect.

(e.g., reduced mortality or morbidity, improved memory, accurate and timely diagnosis)

The well-built clinical question:

INSTRUCTIONS: Fill in the blanks with information from your clinical scenario: THERAPY In_______________, what is the effect of ________________on _______________ compared with _________________?

PREVENTION For ___________ does the use of _________________ reduce the future risk of ____________ compared with ______________? DIAGNOSIS OR DIAGNOSTIC TEST Are (Is) ________________ more accurate in diagnosing _______________ compared with ____________? PROGNOSIS Does ____________ influence ______________ in patients who have _____________?

ETIOLOGY Are ______________ who have _______________ at ______________ risk for/of ____________ compared with _____________ with/without______________? MEANING How do _______________ diagnosed with _______________ perceive __________________?

INSTRUCTIONS: Scenario (check all that apply):

Type of Question

Ideal Type of Study

 Therapy

RCT

 Prevention

RCT > Cohort Study > Case Control

 Diagnosis

Prospective, blind controlled trial comparison to gold standard

 Prognosis

Cohort Study > Case Control > Case Series/Case Report

 Etiology/Harm

RCT > Cohort Study > Case Control

 Cost analysis

economic analysis

Note: Meta-analyses and systematic reviews, when available, often provide the best answers to clinical questions.

INSTRUCTIONS:

OR

AND

Main Concepts (PICO concepts)

MeSH/Subject Headings

Synonyms

Search Strategy Development

INSTRUCTIONS: Finding the right words to get what you want. From your PICO, fill in as much as you can of the table below.

Primary search term

Synonym 1

Synonym 2

P

I

C

O

INSTRUCTIONS: List your inclusion criteria –i.e. gender, age, years of publication

INSTRUCTIONS: Check any limit that may pertain to your search:

_____ Age ___________________ Language __________ Year of publication

Type of study/publication you want to include in your search: (From Step 2 of tutorial)

__ Systematic Review or Meta-Analysis

__ Clinical Practice Guidelines

__ Critically Appraised Research Studies

__ Individual Research Studies

__ Electronic Textbooks

Check the databases you searched:

__ Cochrane Library

__ Joanna Briggs

__ CINAHL with Full Text

__ PubMed Clinical Queries

What information did you find to help answer your question?

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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