Download - Developing a PICO Question for PEN
Developing a PICO Question for PEN
Developed by PEN Canada Team members:Dawna Royall, Tanis Fenton, Kristyn Hall,
Jayne Thirsk and Beth Armour
EBP Information Cycle
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CHE Evidence-based tutorial; 2008
AskTypes of Questions:Background
§ General knowledge, conditions, regulations etc
§ Background document template
Foreground § Specialized knowledge§ About choices / decision
making § PEN PICO question
Background or ForegroundQuestions?
1. How long does it take �food� to enter breast milk and be eliminated from it?
2. Does a breastfeeding mother’s diet contribute to infant colic?
Background Information Sources
n eMedicine (Medscape)
n Mayo Clinic
n Merck Manual Online
n Medline Plus Health Topics (NLM and NIH)
n NIDDK
n disease-related association websites
Population – how would you define your population e.g. demographics, medical condition?
Intervention or Exposure of interest – what are the intervention or prognostic factors?
Comparison – is there an alternative or standard practice to compare to? What comparison is relevant?
Outcome – what do you hope to accomplish, improve or effect? What outcome is important to you and your patients/clients?
PICO Questions
Your PICO terms form your research question
Examples:u Among hospitalized patients, do dietetic
services improve quality of life or mortality?
u Among patients with dysphagia, what is the evidence that modified consistency improves swallowing?
PICO Research Question (example)
u Among hospitalized patients, do dietetic services improve quality of life or mortality?Ø P Ø I Ø C Ø O
PICO Research Question (example)
u Among hospitalized patients, do dietetic services improve quality of life or mortality?Ø P – adults hospitalized for bariatric surgeryØ I – post-op bariatric surgery diet progressionØ C – those post-op bariatric surgery who are allowed to eat ad-libØ O – better quality of life and less incidence of vomiting
PICO Research Question (example)
u Among patients with dysphagia, what is the evidence that modified consistency improves swallowing? Ø P Ø I Ø C Ø O
PICO Research Question (example)
u Among patients with dysphagia, what is the evidence that modified consistency improves swallowing? Ø P – adults with long-term dysphagiaØ I – consuming modified consistency liquid and solid foodsØ C – consuming regular consistency foods and liquidsØ O – fewer incidences of chocking, weight maintenance
Types of inquiry in Nutrition
§ Etiology / Prevention§ Treatment / Intervention
§ Efficacy§ Harm
Ask
Ask
Map questionn Prevention / Etiology
Soy and breast cancer preventionCohort studies
nTreatment / InterventionChromium picolinate and body weightRCTs
Choosing the best study design to address your question
Questiontype Example Studytypes Appraisalissues
Etiologyandriskfactors
Arethereknownfactorsassociatedwithincreasedrisk?
Systematicreviewofcohortstudies,cohortstudies,case-controlstudy
Groupsonlydifferintheoneexposure,controlforconfounding
Intervention Whataretheoutcomesoftheintervention
SystematicreviewofRCTs,RCTs
Randomization,blinding,completefollow-up
*AdaptedfromtheNHMRC2000b,TheEndorsementProcessforEvidence,BaseClinicalPracticeGuidelines,DietitiansAssociationofAustralia2006
Are ___________________________ (P)who have______________________ (E)compared with those without / low__ (C)at ____ risk for _________________ (O)
Treatment / Intervention
Prevention / Etiology
In _____________________ (P)how does _______________ (I)compared with ___________(C)affect __________________ (O)
PICO QuestionPrevention / Etiologyu Are ___________________________(P)u who have______________________ (I)u compared with those without / low___(C)u at ____ risk for __________________(O)
uAre post-menopausal women who have a high consumption of soy products, compared to those with a low intake, at decreased risk for developing breast cancer?
PICO questionTreatment / Intervention u In _____________________ (P)u how does _______________ (I)u compared with ___________(C)u affect __________________ (O)
u In individuals who are overweight (BMI > ? ) how does a daily chromium picolinate supplement, compared with no supplement, affect ones ability to lose weight?
PEN® Training Modules
The following other PEN® Training Modules are available: • Evidence-based Process• Appraising the Literature• PubMed Module• Quick Review of Study Designs
Thank you for your time in reviewing this module.
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