Applied Evidence Based Medicine
Objectives
- Understand how to use PICO to formulate a therapy question
- Learn how to use Pubmed Clinical Queries to limit to the type of studies you're looking for
- Become familiar with resources for understanding therapy studies
PICO for Therapy Questions
When using PICO to frame a therapy question, the P is the patient or disease; the I is the drug or specific procedural intervention; the C is the comparison intervention (or no treatment); and the O is the outcome of interest, such as management of the disease or condition.
Here are a couple of examples of how you would form an answerable therapy question using PICO:
Scenario 1: Your preceptor wants you to undertake a literature search for her. She's interested in whether acetaminophen is better than ibuprofen at reducing fever in young children.
P: young children
I: acetaminophen
C: ibuprofen
O: reduced fever
Clinical Question: Is acetaminophen more effective than ibuprofen at reducing fever in young children?
Scenario 2: You're a family physician caring for an elderly patient with dementia. You are currently using donepezil to treat her cognitive and behavioural symptoms, but her son asks you if there are other non-medicinal treatments to help manage his mother's agitation. He has heard that music therapy has positive effects on patients with his mother's condition.
P: elderly woman with dementia
I: music therapy
C: other non-medicinal treatments
O: reduced agitation
Clinical Question: Can music therapy or other non-medicinal treatments be used to reduce agitation in elderly patients with dementia?
Using PubMed Clinical Queries to Answer a Therapy Question
- PubMed Clinical Queries Part 1: Basic Searching (video tutorial)Introduces PubMed Clinical Queries, using a basic therapy search as an example.
- PubMed Clinical Queries Part 2: Advanced Search Tips (video tutorial)Shows how to incorporate more complex searching skills into your PubMed Clinical Query.
Key Points to Remember about PubMed:
- Clinical Queries allows for more focused searching that brings back more relevant results than the main PubMed search
- Make sure you access PubMed through the UCalgary library website, or bookmark our special PubMed link to ensure you get links to our e-journals with your search results
- Use these search tips to improve the quality of your search (for a further explanation of these search tips, see UCalgary Libraries' video suite Building Blocks for Library Research):
Resources for Understanding Therapy Studies
- Chapter 4. In: Straus SE, Glasziou P, Richardson WS, Haynes RB. Evidence-Based Medicine: How to Practice and Teach It. 5th ed. Edinburgh: Elsevier; 2019.This chapter tackles the critical appraisal of therapy articles, looking specifically at individual trials, systematic reviews, qualitative studies, clinical decision analyses, and clinical practice guidelines.
- Chapters 6-11. In: Guyatt G, Rennie D, Meade MO, Cook DJ. eds. Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 2nd ed. New York, NY: McGraw-Hill; 2008.These chapters discuss how to find and assess evidence for a therapy question, with a focus on randomized controlled trials.
- An Introduction to Randomized Controlled Trials (video)This video from SAGE Research Methods introduces the concept of randomized controlled trials (RCTs), the impact of randomization, and instances in which quasi-experimental study designs may be used.
- Cardarelli R, Virgilio RF, Lockwood T. Evidence-based medicine, part 2. An introduction to critical appraisal of articles on therapy. J Am Osteopath Assoc. 2007;107(8):299-303.This article provides an introductory, step-by-step process to appraise a therapeutic article, including the process of assessing its validity, determining its importance, and applying it to an individual patient.
- Stolberg H, Norman G, Trop I. Randomized controlled trials. Am J Roentgenol. 2004;183(6):1539-1544.This article provides a concise overview of RCTs.
- The NNT, ExplainedAn explanation of how Number Needed to Treat (NNT) is calculated.
- GATE CAT for Intervention StudiesThis Excel-based workbook from the University of Auckland walks users through the critical appraisal process for an intervention study.
- Centre for Evidence-Based Medicine Therapy Critical Appraisal WorksheetDownload this worksheet to help you appraise an RCT.
- Last Updated: Sep 6, 2023 5:34 PM
- URL: https://libguides.ucalgary.ca/guides/AEBM
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