Clinical Reasoning: using PICO

Views:
 
Category: Education
     
 

Presentation Description

No description available.

Comments

Presentation Transcript

Slide 1: 

Clinical Reasoning: Using PICO Wellington Medical and Health Sciences Library

Slide 2: 

Where do you start?

Slide 3: 

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

Slide 4: 

…and find an answer!

Slide 5: 

PICO is a framework for building searchable clinical questions

Slide 6: 

Let’s use an example!

Slide 7: 

I saw Mr X today, a 65 yr old with a 6 month history of atrial fibrillation resistant to cardioversion. There’s no evidence of valvular or coronary heart disease, but the referring GP wants advice on if the long-term benefits of anticoagulants such as Warfarin to reduce chance of embolic stroke outweigh the risks of their use, such as haemorrhage.

Slide 8: 

So… what questions could we ask?

They could relate to prevalence… : 

I saw Mr X today, a 65 yr old with a 6 month history of atrial fibrillation resistant to cardioversion. There’s no evidence of valvular or coronary heart disease, but the referring GP wants advice on if the long-term benefits of anticoagulants such as Warfarin to reduce chance of embolic stroke outweigh the risks of their use, such as haemorrhage. They could relate to prevalence… Q: How common is it?

Or prognosis… : 

I saw Mr X today, a 65 yr old with a 6 month history of atrial fibrillation resistant to cardioversion. There’s no evidence of valvular or coronary heart disease, but the referring GP wants advice on if the long-term benefits of anticoagulants such as Warfarin to reduce chance of embolic stroke outweigh the risks of their use, such as haemorrhage. Or prognosis… Q: What would be the outcome if I did nothing?

Or most often, treatment! : 

I saw Mr X today, a 65 yr old with a 6 month history of atrial fibrillation resistant to cardioversion. There’s no evidence of valvular or coronary heart disease, but the referring GP wants advice on if the long-term benefits of anticoagulants such as Warfarin to reduce chance of embolic stroke outweigh the risks of their use, such as haemorrhage. Or most often, treatment! Q: What are the risks and benefits?

Slide 12: 

To frame a question, use PICO

Slide 13: 

A method for building a question using…

Slide 14: 

…plus…

Slide 15: 

…then…

Slide 16: 

…and finally…

Slide 17: 

That’s

Slide 18: 


Slide 19: 

For some questions…

Slide 20: 

You’ll only need a...

Slide 21: 

…or even just a...

Slide 22: 

Using the example… I saw Mr X today, a 65 yr old with a 6 month history of atrial fibrillation resistant to cardioversion. There’s no evidence of valvular or coronary hear disease, but the referring GP wants advice on if the long-term benefits of anticoagulants such as Warfarin to reduce chance of embolic stroke outweigh the risks of their use, such as haemorrhage.

Slide 23: 

P I C O Adults with nonvalvular atrial fibrillation Warfarin Placebo Risk of emboli or complications of anitcoagulation

Slide 24: 

Where there is no comparison

Slide 25: 

P I C O Adults with nonvalvular atrial fibrillation Warfarin Placebo Risk of emboli or complications of anitcoagulation Leave the C out!

Slide 26: 

So that’s…

Slide 27: 

In adults with nonvalvular atrial fibrillation, would the benefits of long-term anticoagulants such as warfarin outweigh risk of embolism or other complications? P I O

Slide 28: 

The next step is…

Slide 29: 

P I O Adults with nonvalvular atrial fibrillation Warfarin Risk of emboli or complications of anticoagulation Brainstorming!

Slide 30: 

To prepare for the research process…

Slide 31: 

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

Slide 32: 

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

Slide 33: 

If yes, write them down!

Slide 34: 

For example, for ntervention I Warfarin OR other anticoagulants?

Slide 35: 

Even better…

Slide 36: 

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

Slide 37: 

Once you’ve done your brainstorm…

Slide 38: 

Let’s use an example! AND OR You’re ready to build your search using the magic words…

Slide 39: 

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

authorStream Live Help