When writing a Evidence Based Paper, can you have a 3rd comparison?

[CrazyCoconut]

I understand that in PICO, there's normally one method compared to another method. But can you have a 3rd method just to toss in there as well? Or would that be pointless in a EBP? I have a topic about NGT placement but I have a 3rd option (x-rays, film) with alot of research praising this method. Should I toss out one method like ascultating?

[llg, PhD, RN]

That's a REALLY good question ... and one of those "little" things about most EBP models that can be troublesome. In research, there are ways to have 3 or more groups to compare. There are statistical techniques to compare the outcomes among mulitiple groups. However, those statistics are more sophisticated than most people in practice are able to do. So, unless you have a statistician on your team, it's generally not a good idea to try such a project.

The whole idea of EBP is to take the research that's been done (which might have involved multi-group comparisons) and combine that evidence with the specific characteristics and evidence from your workplace to make the best decision for your particular setting and situation. It "assumes" that the you can determine the "1 best recommendation" from the scientific evidence (e.g. research literature) ... and compare that "new" intervention with what you are currently doing. Those 2 approaches (the one from the literature vs. the one you are using now) become your 2 comparison groups. It's best to leave it at that -- unless you are ready for advanced work.

If you find yourself believing that there IS not "1 best approach" identified in the scientific literature ... then what you may need to do is a research project, not an evidence-based practice project. (But I can imagine EBP projects with more than 2 groups.)

[CrazyCoconut]

Thank you, I e-mailed my professor for clarification. It's a little tricky and I'd imagine 3 interventions SHOULD be ok but you're correct in that it might lean more to research...