Evidence-Based Practice in Health

This guide includes a tutorial about Evidence-Based Practice (EBP) in Health, a Reference Shelf of supporting eBooks, and a Toolkit of online sources of evidence.

• Introduction
• Module 1: Ask
  • PICO Framework and the Question Statement
    • Using the PICO Framework
    • Writing Your Question Statement
    • References
    • Selecting a Resource
    • Searching PubMed

    Using the PICO Framework

    PICO Framework

    Without a well-focused question, it can be very difficult and time consuming to identify appropriate resources and search for relevant evidence. Practitioners of Evidence-Based Practice (EBP) often use a specialized framework, called PICO , to form the question and facilitate the literature search. 1 PICO stands for:
    

    Framework item:	Think about:	Example:
    P atient Problem (or Population)	What are the patient's demographics such as age, gender and ethnicity? Or what is the or problem type?	Work-related neck muscle pain
    I ntervention	What type of intervention is being considered? For example is this a medication of some type, or exercise, or rest?	Strength training of the painful muscle
    C omparison or Control	Is there a camparison treatment to be considered? The comparison may be with another medication, another form of treatment such as exercise, or no treatment at all.	Rest
    O utcome	What would be the desired effect you would like to see? What effects are not wanted? Are there any side effects involved with this form of testing or treatment?	Pain relief

    
    When forming your question using PICO , keep the following points in mind:

    • Your P atient is a member of a population as well as a person with (or at risk of) a health problem. So, in addition to age and gender, you may also need to consider ethnicity, socioeconomic status or other demographic variables.
    • A C omparison is not always present in a PICO analysis.
    • O utcomes should be measurable as the best evidence comes from rigorous studies with statistically significant findings.
    • An O utcome ideally measures clinical wellbeing or quality of life, and not alternates such as laboratory test results.

    PICO Elements Change According to Question Type (Domain)

    When forming your question using the PICO framework it is useful to think about what type of question it is you are asking, (therapy, prevention, diagnosis, prognosis, etiology). The table below illustrates ways in which P roblems, I nterventions, C omparisons and O utcomes vary according to the t ype (domain) of your question. 2