Foreground questions seek evidence to answer a need for clinical information related to a specific patient, an intervention or therapy. Identifying the PICO (T)* elements helps to focus your question:
Example question: Does handwashing among healthcare workers reduce hospital acquired infection?
|P (problem/patient/population)||hospital acquired infection|
|C (comparison)||no handwashing; other solution; masks|
|O (outcome of interest)||reduced infection|
To begin a database search your initial strategy should begin with the P and the I only:
Viewing the initial article results, you may decide to narrow your search with terms for the Comparison and Outcome.
(Some models of EBP add in T (PICOT) for time factor or type of study. Other models add C for Context (PICOC). You can add limits for time, type of study, or other contextual limits, later. Keep the initial search broad.
As you browse results, abstracts, and the full text of articles you will locate the narrower Comparative terms, Outcome measures and type of study elements, but keep the initial search broad.
The box on the right links to more sample PICO questions and search strategies.
The tutorial continues with FILTERING your results to capture the best evidence.
Click on the Forward button to go to Module 2.4
*Heneghan, C., & Badenoch, D. (2002). Evidence-based medicine toolkit. London: BMJ Books.
Models of EBP describe the evidence-based process in 5 steps: