How to Form an Answerable Clinical Question Online Tutorial, Cincinnati Children's Hospital Medical

Office Of Continuing Education

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Tutorial:How to Form an Answerable Clinical QuestionIf you have any questions about this material, please contact the Clinical Effectiveness Education Specialist at x60396.October 17, 2006Learning Objectives• Identify the model to create a well-built Clinical Question• Differentiate between the various Evidence-Based Care Types of Questions / Study Designs• Review Clinical Scenarios There are five steps to providing Evidence-Based Care (EBC):You are here1. ASK = Develop your answerable clinical question2. ACQUIRE = Efficiently find the best evidence3. APPRAISE = Critically evaluate the evidence for its validity and usefulness4. APPLY = Use the results of the appraisal in your clinical practice5. ASSESS = Evaluate your performancendSackett DL, Straus SE,et al. Evidence Based Medicine: How to Practice and Teach EBM. 2 Ed. Churchill Livingstone: Edinburgh, 2000. Efficiency is Key• Finding the right information in the most efficient manner is key to successfully practicing evidence-based decision making. • Knowing what key components to use in your search strategy will help you develop that efficiency.• These key components of interest are:– Patient/Population– Intervention/Exposure–Comparison–O utcom e The Well-Built Clinical Question: “PICO” Model• Patient / Population / Problem (among _____)• Intervention / Exposure (does _____)• Comparison (versus ______) • Outcome (affect _______)P = Patient/Population of Interest• Who are ...

Informations

• Publié par: Anyi
• Nombre de lectures: 42
• Langue: English

Extrait

Tutorial: How to Form an Answerable Clinical Question If you have an E y f   f q ec u t e iv st e i n o e n s s  s a  E bo d u u t c  t a h ti is o   n m  S at p e e r c i i a a l, l   is p t l   e a a t  s x e 6  c 0 o 3 n 9 t 6 a . ct the Clinical  October 17, 2006

• • • Learning Objectives Identify the model to create a well-built Clinical Question Differentiate between the various Evidence- Based Care Types of Questions / Study Designs Review Clinical Scenarios

There are five steps to providing Evidence-Based Care (EBC): You are ereh 1. ASK = Develop your answerable clinical question 2. ACQUIRE = Efficiently find the best evidence 3. APPRAISE = Critically evaluate the evidence for its validity and usefulness 4. APPLY = Use the results of the appraisal in your clinical practice 5. ASSESS = Evaluate your performance Sackett DL, Straus SE,et al. Evidence Based Medicine: How to Practice and Teach EBM. 2 nd Ed. Churchill Livingstone: Edinburgh, 2000.

• • • Efficiency is Key Finding the right information in the most efficient manner is key to successfully practicing evidence-based decision making. s K tr n a o t w e i g n y g     w w ill h   a h t e   l k p e   y y   o c u o  d m e p v o e n l e o n p t  t s h  t a o t     u ef s fi e c  i i n e   n y c o y u . r search  These key components of interest are: –Patient/Population –Intervention/Exposure –Comparison –Outcome

•O •C •I n •P The Well-Built Clinical Question: “PICO”Model )_______ tceffa( emoctu  )______susrev( nosirapmo )_____seod( erusopxE / noitnevret )_____gnoma( melborP / noitalupoP / tneita

P= Patient/Population of Interest • • • • Who are the patients of interest? Is there a particular age group, gender or population? What is the health concern? Example: For persons entering a health care facility……

• • • I= Intervention or Exposure What therapeutic, diagnostic, preventive or other health care interventions are you interested in knowing more about? What health care management strategies are you interested in comparing? Example: For persons entering a health care facility, is hand rubbing with a waterless, alcohol- based solution…..

• • • C= Comparison of Interest Is there a comparison to be evaluated against the intervention? Only used if more than one intervention or if no intervention is a factor. Example: For persons entering a health care f b a a c s il e it d y   ,  s i o s l   u h t a io n n d ,     r a u s b   b e i ff n e g c   t w iv it e h     a a s     w st a a te n r d le a s rd s   , h a a lc n o d hol- washing with antiseptic soap…..

• • • O= Outcome of Interest What is the desired outcome to be evaluated? How will the patient or population be affected, or not affected, by the intervention? Example: For persons entering a health care facility, is hand rubbing with a waterless, alcohol- based solution, as effective as standard hand washing with antiseptic soap for reducing hand contamination? E Pr x a a c m ti p c l e e .     f   r S o t. m  L :  o D u i i C s, e   n M s O o  :  A M ,  o G s u b y y a . tt G, Ciliska D. (2005). Evidence-Based Nursing: A Guide to Clinical 

• • In addition to the PICO elements of your clinical question, it’s important to know: –What TYPE of question are you asking? –What is the best STUDY DESIGN to search for to find evidence to answer your clinical question? So let’s look at how to add these to the PICO model ….

P  I C O T T aPitne,t  fo P. r I   . C C l . in O i . c ( a T l .   T Q .) ue M s o ti d o e n l  s oPupalitno ,roP orlbme Intervention, Prognostic Factor, or Exposure Comparison to Intervention (if appropriate) Outcome you would like to measure or achieve What type of question are you asking? yTepo  ftsdu yoy uawtnt  oifdn How would I describe a group of patients similar to mine? Which main intervention, prognostic factor, or exposure am I considering? What is the main alternative to compare with the intervention? What can I hope to accomplish, measure, improve or affect? Therapy/Treatment, Diagnosis, Prognosis, Harm/Etiology (may be referred to as “domains”in PubMed) What would be the best study design/methodology?