This guide focuses on the second and third components of the EBM process.
It is important to remember that when seeking evidence that not all evidence is equal. It is important to seek out the recommended study level as well as evaluate the evidence.
Use the PICO(TT) Format to develop specific and answerable clinical questions.
PICO Format | Definition & Questions to Consider |
---|---|
P | Patient, Population, or Problem What are the characteristics of the patient or population? What is the condition or disease in which you are interested? |
I | Intervention or Exposure What do you want to do with this patient (e.g., treat, diagnose, observe)? |
C | Comparison or Intervention (if appropriate) What is the alternative to the intervention (e.g., placebo, different drug, surgery)? |
O | O = Outcome What are the relevant outcomes (e.g., morbidity, death, complications)? |
T | Type of Clinical Question Diagnosis, Etiology/Harm, Therapy, Prognosis, Prevention |
T | Type of Study Design to Answer the Question What would be the best study design/methodology (Systematic review, RCT, cohort study, case control, etc.) |
*Descriptions from the University of Washington Evidence-Based Practice LibGuide at http://libguides.hsl.washington.edu/content.php?pid=231619&sid=1931590
Knowing the Type of Clinical Question will help you determine the best type of study design. The table* below demonstrates the types of studies generally recommended to answer particular types of clinical questions.
Type of Question | Type of Study/Methodology |
---|---|
Diagnosis | controlled trial |
Therapy | double-blind RCT, Systematic review / meta-analysis |
Prognosis | cohort studies, case control, case series |
Harm/Etiology | cohort studies, case control, case series |
Prevention | randomized controlled trial, cohort studies |
Quality improvement | Randomized controlled trials |
*Table adapted from http://researchguides.uic.edu/content/php?pid=47981&sid=353409
For Diagnosis | For Prognosis | For Risk, etiology or harm | |
---|---|---|---|
P | Patient | Patient | Patient |
I | Test |
Prognostic Factors (Such as: disease state, comorbidity, or demographic factor) |
Risk Factor |
C | Standard | Absence of Prognostic Factors | Absence of Risk Factors |
O | Outcome | Outcome | Outcome |
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