How to Form an Answerable Clinical Question Online Tutorial,  Cincinnati Children

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

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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 ...

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Tutorial:How to Form an Answerable Clinical QuestionIf you have anEyf fqecuteivsteinoenss sa Eboduutc tahtiiso nm Satpeerciiaal,l isptl eaat sxe6 c0o3n9t6a.ct the Clinical October 17, 2006
•••Learning ObjectivesIdentify the model to create a well-built Clinical QuestionDifferentiate between the various Evidence-Based Care Types of Questions / Study DesignsReview Clinical Scenarios
There are five steps to providing Evidence-Based Care (EBC):You are ereh1. 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 performanceSackett DL, Straus SE,et al. Evidence Based Medicine: How to Practice and Teach EBM. 2ndEd. Churchill Livingstone: Edinburgh, 2000.
•••Efficiency is KeyFinding the right information in the most efficient manner is key to successfully practicing evidence-based decision making. sKtrnaotweignyg  wwillh ahte lkpe yy ocuo dmepvoenleonpt tsh taot  uefsfiec iine nycoyu.r search These key components of interest are:–Patient/Population–Intervention/Exposure–Comparison–Outcome
•O•C•In•PThe 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 ExposureWhat 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 InterestIs 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 fbaacsileitdy , siosl uhtaionnd,  rausb beiffnegc twiviteh  aas  wstaatenrdleasrds , haalcnod hol-washing with antiseptic soap…..
•••O= Outcome of InterestWhat 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?EPrxaacmtipclee.  f rSot.m L: oDuiiCs,e nMsOo : AM, oGsubyya.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 ICOTTaPitne,t foP.rI .CCl.inOi. c(aTl. TQ.)ueMsotidoenl soPupalitno ,roP orlbmeIntervention, Prognostic Factor,or ExposureComparison to Intervention (if appropriate)Outcome you would like tomeasure or achieveWhat type of question are youasking? yTepo  ftsdu yoy uawtnt  oifdnHow 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?