EBCP: asking answerable PICO questions

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EBCP: asking answerable PICO questions

  1. 1. Asking Answerable Questions<br />SohailBajammal<br />October 6, 2011<br />
  2. 2. Outline<br />Types of questions<br />Good questions<br />Why do we need to ask good questions?<br />
  3. 3. EBM (EBCP)<br />Research Evidence<br />Patients’ Preferences<br />Clinical Expertise<br />Clinical Circumstances<br />Haynes et al. BMJ 2002;324:1350<br />
  4. 4. Steps of Practicing EBCP<br />
  5. 5. Types of Questions<br />Background questions:<br />About the condition<br />5W questions (who, what, when, why, where, how)<br />General knowledge<br />Look up the answers in textbooks<br />Foreground questions:<br />About the options<br />Specific information<br />Look up the answers in the literature (articles)<br />
  6. 6. Back Pain<br />Which of the following are background questions & foreground questions?<br />What is the pathophysiology of back pain?<br />What are the causes of back pain?<br />How can we diagnose back pain?<br />What is the best diagnostic test for back pain?<br />What are the treatments available for back pain?<br />What is the best treatment for back pain?<br />B<br />F<br />B<br />B<br />B<br />F<br />B<br />F<br />
  7. 7. Is this a good foreground question?<br />What is the best treatment for back pain?<br />
  8. 8. Is this a good foreground question?<br />In adult patients younger than 50 years old with acute low back pain (< 6 weeks), does bedrest reduce the risk of recurrence of pain within one year compared with physiotherapy?<br />P: Adult patients <50yr with acute LBP<br />I: Physiotherapy<br />C: Bedrest<br />O: Recurrence of pain within one year<br />
  9. 9. Which is a better question?<br />What is the best treatment for back pain?<br />In adult patients younger than 50 years old with acute low back pain (< 6 weeks), does bedrest reduce the risk of recurrence of pain within one year compared with physiotherapy?<br />
  10. 10. PICO<br />P: Population (or problem)<br />I: Intervention<br />C: Comparison (control)<br />O: Outcome<br />
  11. 11. Questions Categories<br />Diagnosis<br />Prognosis<br />Therapy (Treatment)<br />Harm/Causation<br />Prevention<br />Cost (Economic)<br />Qualitative<br />
  12. 12. Class Activity<br />10 minuets<br />Split into groups of 5<br />Think of a foreground question<br />From the topics you studied the last 2 weeks<br />PICO format<br />What category?<br />Be prepared to discuss with the group<br />
  13. 13. Your PICO questions – 40 minutes<br />
  14. 14. Why do we need to PICO?<br />Keep the question patient-oriented<br />POE (patient-oriented evidence) vs DOE (disease-oriented evidence)<br />Make searching effective & focused<br />Will help you in designing your search strategy<br />Will make you think of what type of study you will be looking for<br />What category <br />
  15. 15. What we have discussed<br />Types of questions: background & foreground<br />Good foreground questions are PICO<br />Why do we need to ask good questions?<br />

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