LO 2 Flashcards
The PICO process was developed as a means for converting information needs and problems into __________, so they can be answered
clinical questions
What does PICO stand for?
P - Person/Population
I - Intervention
C - Comparison
O - Outcome
What is the importance of the search for evidence?
- Save time in the long run
- Build good search habits
- Safety of the client
What is the FRIAR mnemonic for preparing an effective search strategy
F - Frame
R - Relevance
I - Irrelevance
A - Aliases
R - Review/Repeat
Describe framing the question
When a client asks you about a certain condition/product/therapy, you need to know WHAT they are actually asking you and what is relevant in their situation.
PICO was first proposed in _________
1995
What elements of the person/population should the researcher consider?
- Fundamental characteristics such as sex, age, or age range
- Other characteristics that may influence a condition, treatment or ability to identify an answer (race, current or prior pregnancy status, SES, social support resources, etc.)
- Specific medical characteristics used to identify patient group of interest (age at diagnosis, state at diagnosis, response to treatment, etc.)
What are the options for intervention?
- Actions performed by a health care practitioner (HCP) with the intent to correct, improve, or prevent a health challenge, condition or disease
- Actions performed by a patient under the advice of the HCP
- Actions performed by patients of their own choice
- External events or circumstances imposed upon patients with or without consent
What are the options for comparison/control?
- Patient comparison or control group (alternative intervention, placebo, no intervention)
- Non-patient comparison group ( general population or recognized statistical norms)
- Alternative patient population
- Treatment or methodology comparison or control
What are the options for outcomes?
- Survival/disease-free survival which may be part of the patient, of an installed device or an original body part (e.g. dental implant, tooth, chewing surface, tissue)
- Correction, measurable improvement or reduced incidence of disease, diagnosis or presenting symptom of interest
- Measurable difference in specific relevant test results or abilities
__________ may be required if you can’t immediately determine the PICO components
Background research
Background questions usually concern conditions, and consist of two parts: __________
- The root question (who, what, where, when, why, how?)
- Problem
What is the difference between background and foreground questions?
Background
1. General knowledge, broad
2. Help narrow a broad scope
3. Identify articles that provide more specific details to a broad question
4. Ask: who, what, where, why, how
Foreground
1. Specific
2. Identify P,I,C,O
3. Structured to find a precise answer and phrased to facilitate a computerized research
4. Identify valid evidence to answer a specific question
What are the modifications of PICO?
- PICOT T= time/ time frame
- PIO = patient, intervention, outcome
- PIC = patient , intervention , control
What is the importance of time/time frame for PICO?
- Temporal factors are relevant to many conditions; healing or improvement
- This format is used when the topic or question is broad or when the initial test search is a very large number
- This makes a more focused search strategy with fewer results
When are PIO and PIC used instead of PICO?
- Too few results are being found
- Results found are not answering the question
- Topic of interest has a relatively small research base
- Dentistry is considered to have a small research base in comparison to medicine (cancer, for example)
What are the 4 types of questions that may be answered with PICO?
- Etiology - what is the underlying cause
- Diagnosis - What is happening
- Treatment/Therapy - what is the best way to improve the issue
- Prognosis - how will this progress into the future
*recommended acronyms – EDTP, DEPT
Describe etiology
- Science of causation
- Focuses on what happened before the condition began
- Useful in preventing a condition from spreading to other people in the family or community
- It’s the “why” and the “who”
Describe diagnosis
- Diagnosis is the “what” and the “where”
- Looks for evidence to determine the degree to which a test is reliable and useful.
Describe treatment/therapy
- Focuses on guiding the process through time to a desired conclusion
- “what to do” and “what not to do”
- Drives search for alternative treatments as well as risks and benefits
- Look for answers that determine the effect of treatments, avoid adverse events, improve function, and are worth the effort and cost.
Describe prognosis and prevention
- Prognosis = expected outcome
- Prevention = preventing a disease OR preventing harm from treatment Think “if this, then what”?
- Look to studies that estimate the clinical course or progression of a disease or condition over time and anticipate likely complications (and prevent them)
