- 0Feb 3, '13 by Crescentmoon1021Hello everyone!
I have been having a hard time creating a PICO question that has research articles that have been peer reviewed, at most 5 years old and done in the united states. I have tried breastfeeding vs bottled feeding, and reduction of labor pains through guided imagery (which was approved as a topic) and have little results. I have been trying to create PICO questions and then searching for them before I send the topic to my Professor for approval, but little luck. If someone could help me in the right direction I would be be greatly appreciating the help!
- 0Feb 4, '13 by Esme12, BSN, RN Senior ModeratorI think I may have found something to help you........Asking the right question is a difficult skill to learn, yet it is fundamental to the evidence-based decision-making process. This process almost always begins with a patient question or problem. A "well-built" question should include four parts, referred to as PICO that identify the patient problem or population (P), intervention (I), comparison (C) and outcome(s) (O). 1 The first step in developing a well-built question is to identify the patient problem or population. Describe either the patient's chief complaint or generalize the patient's condition to a larger population.
When identifying the P in PICO it is helpful to ask:How could you describe a group with a similar problem?The P phrase could be more detailed if the added information influences the results you expect to find.
How you would describe the patient to a colleague?
What are the important characteristics of this patient?
- Primary Problem
- Patient's main concern or chief complaint
- Disease or health status
- Age, Race, Sex, Previous ailments, current medications
Should these characteristics be considered as I search for evidence? 1
Identifying the Intervention is the second step in the PICO process. It is important to identify what you plan to do for that patient. This may include the use of a specific diagnostic test, treatment, adjunctive therapy, medication or the recommendation to the patient to use a product or procedure. The intervention is the main consideration for that patient or client. 1
The Comparison is the third phase of the well-built question, which is the main alternative you are considering.1 It should be specific and limited to one alternative choice in order to facilitate an effective computerized search.
The Comparison is the only optional component in the PICO question. One may only look at the Intervention without exploring alternatives, and in some cases, there may not be an alternative.
The Outcome is the final aspect of the PICO question. It specifies the result(s) of what you plan to accomplish, improve or affect and should be measurable. Outcomes may consist of:relieving or eliminating specific symptomsSpecific outcomes will yield better search results and allow you to find the studies that focus on the outcomes you are searching for. When defining the outcome, more effective is not acceptable unless it describes how the intervention is more effective.
improving or maintaining function
or enhancing esthetics.For example, more effective in preventing caries, or in decreasing probing depths.In addition to identifying the PICO components, it is important to clarify the type of question you are asking and the related research method. The categories for types of questions are:Therapy/PreventionBased on four PICO component, a final PICO question can be stated as:
For a patient with Tetracycline staining, will chairside (ZOOM) bleaching as compared to over the counter White Stips decrease staining and increase tooth whiteness.
Once you have identified a patient problem and defined your question using PICO, you are ready to find the most current valid evidence.
The PICO Worksheet and Search Strategy provides the framework for developing this step of the process by guiding one to write each component of the PICO question and is also a guide in developing a search strategy, which aids in the retrieval of relevant clinical evidence.
Conducting a computerized search with maximum efficiency to answer the question is the second step in the EBDM process http://www.usc.edu/hsc/ebnet/ebframe/PICO.htm
LINKS to PICO Resources