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Occupational Therapy - Denton

Evidence-Based Practice Basics

3 Pillars of Evidence-Based Practice

    1. EVIDENCE derived from rigorous scientific research found in literature.

    2. EXPERTISE derived from clinical experience and skill.

    3. PATIENT PREFERENCE concerning personal health decisions.


Steps in the EBP Process

Steps in the EBP process

Asking for and locating evidence depends upon asking an effective clinical question.
Use the PICO mnemonic to build that question.

P =   Patient     Population     Problem  (includes demographic information)

I   Intervention   Treatment    Therapy     Prognostic Factor    Exposure

C  =  Comparison  (could be placebo or no treatment)

O  =  Outcome       (what you hope to accomplish; measurable)

 

P I C O

     P -- patient, population, participant, problem (diagnosis)
     I -- intervention, therapy, treatment
     C -- comparison  (not always required)
     O -- outcome


P I C O T

     P -- patient, population, participant, problem (diagnosis)
     I -- intervention, therapy, treatment
     C -- comparison  (not always required)
     O -- outcome

     T  -- time


P I C O (T)

     P -- patient, population, participant, problem (diagnosis)
     I -- intervention, therapy, treatment
     C -- comparison  (not always required)
     O -- outcome

     T  -- type of studies or questions


P I C O T T

     P -- patient, population, participant, problem (diagnosis)
     I -- intervention, therapy, treatment
     C -- comparison  (not always required)
     O -- outcome

     T  -- type of question 
              (therapy/treatment, diagnosis, prognosis, harm/etiology)

     T  -- type of study 
              (research method/design)

 5 Types of PICO Questions

     1. Diagnosis
     2. Therapy (treatment / intervention)
     3. Etiology (cause)
     4. Prognosis (future / forecast)
     5. Prevention

Diagnosis PICO:
In children with respiratory infection, is the respiratory rate as effective as chest x-ray in detecting pneumonia?

Prognosis PICO
:
In premature infants (compared to full-term infants), what is the lifetime prevalence of hearing deficit?
 

Therapy PICO:
In patients with recurrent infection, do antibiotics, compared to no treatment, reduce recurrence rate?
 

Etiology PICO:
In post-menopausal women, does hormone replacement therapy increase the risk of breast cancer?

Building a P I C O Question

PICO Search Method

Critical Appraisal Help