Framing your search: Using PICOT

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Framing your search: Using PICOT Wellington Medical and Health Sciences Library

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Or…

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Turning a challenge… …into a clinical question… …into a search strategy

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Where do you start?

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A challenge to your current knowledge is an opportunity to ask a question Q

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…and find an answer! A

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By recording and reflecting on your workplace challenges…

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Q …you become a life long learner… Q A A Q A

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And a valuable employee!

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Let’s use an example!

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I saw Mrs X today. She has mixed urinary incontinence. Usually I’d suggest pelvic floor training for stress incontinence and bladder training for urgency incontinence…

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Because she has both stress and urgency incontinence I didn’t know whether to treat them both at once, or one at a time. In the end I asked her which was more troubling, and treated it first… but I don’t know if that was the best thing to do…..?

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So… what questions could we ask?

They could relate to prevalence…:

They could relate to prevalence… I saw Mrs X today. She has mixed urinary incontinence. Usually I’d suggest pelvic floor training for stress incontinence and bladder training for urgency incontinence… Q: How common is it?

Or prognosis…:

Or prognosis… I saw Mrs X today. She has mixed urinary incontinence. Usually I’d suggest pelvic floor training for stress incontinence and bladder training for urgency incontinence… Q: What would be the outcome if I did nothing?

But really…this is a question about treatment!:

But really…this is a question about treatment! Q: Which is best, when ? I saw Mrs X today. She has mixed urinary incontinence. Usually I’d suggest pelvic floor training for stress incontinence and bladder training for urgency incontinence…

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To frame a question, use PICOT

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What is PICOT?

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A method for building a question using… for population P Start with the person in your challenge… how can I describe this person to find the best studies?

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…plus… for intervention I Sometimes “E” for exposure… what will they be exposed to, how can I best describe the treatment?

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…then… for comparison C What is the main thing I want to compare this exposure or intervention with?

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…also… for outcome O What do I want to change or accomplish? What will this exposure really affect?

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…and finally… for time T When do I want to see this effect?

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That’s

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population P Intervention/exposure I comparison C outcome O time T

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For some questions…

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You’ll only need a... population P Intervention/exposure I outcome O

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…or a... population P Intervention/exposure I outcome O T time

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Using the example… I saw Mrs X today. She has mixed urinary incontinence. Usually I’d suggest pelvic floor training for stress incontinence and bladder training for urgency incontinence…

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P I C O T In a woman with mixed urinary incontinence… f …would adding pelvic floor muscle training to bladder training… …when compared with one of these treatments alone… …lead to fewer leakage episodes and better quality of life… …six months or more after treatment ceases?

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The next step is…

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P I C O T In a woman with mixed urinary incontience … f …would adding pelvic floor muscle training to bladder training… …when compared with one of these treatments alone… …lead to fewer leakage episodes and better quality of life… …six months or more after treatment ceases? Brainstorming your PICOT

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To prepare for the research process…

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…it’s important to look at the ideas and words in your PICOT…

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Are there… Synonyms? Regional spellings? Broader terms? Narrower terms?

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Write it down!

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For example, for ntervention I Pelvic floor muscle training, pelvic floor exercises, kegel exercises…

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Even better…

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Make another column for your brainstorm terms What are the alternatives?

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Once you’ve done your brainstorm…

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PICOT Breakdown Brainstorm terms

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You’re ready to build your search using the magic words…

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Let’s use an example! AND OR ….and…

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The best way to search your PICOT?

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Search either your population combined with your intervention, outcome or both P I O P I P O OR OR

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Depending on the number of search results…

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…then add your comparison or time to further narrow your search C T P I O PLUS OR

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For more, visit www.uow.otago.ac.nz/medlibrary.html Wellington Medical and Health Sciences Library

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