This tutorial assumes that you have a basic knowledge of what evidence-based health care is all about. If you need to refresh your memory about EBM's principles and history, visit "Evidence-Based Medicine - what it is and what it isn't" by David L. Sackett, et al. or Users' Guides to Evidence-Based Practice from Centres for Health Evidence. Now we are going to go through the steps to build better information seeking skills into your evidence-based clinical practice.
A. Identify the clinical issue for which you need more information. This is usually related to a specific patient or group of patients.
Clinical scenario: Our patient is a 45-year-old female who is experiencing moderate depression. After surfing the web, she believes St. John's Wort will cure her symptoms with less risk than conventional antidepressant medications.
B. Define your clinical problem using the PICO components described below:
From our Clinical Scenario:
P - adults experiencing (moderate) depression
I - St. John's Wort
C - antidepressants
O - relief of symptoms
C. Write out your clinical Question using the PICO components.
By writing out a question, you help clarify exactly what you need to answer. The results of your search will only be as good as the initial question that you ask. Some of your questions will be background or fundamental questions and others will be much more detailed questions as shown in our example. Often the level of your question is based on your previous knowledge of the topic.
From our Clinical Scenario: For adult patients with moderate depression, is St. John's Wort (hypericum) more effective for symptom relief than antidepressants?
For more information about creating answerable questions, read:
"Asking answerable clinical questions" in D.L. Sackett, S.E. Straus, W.S.
Richardson, W. Rosenberg, and R.B. Haynes. Evidence-based Medicine: How
to Practice and Teach EBM. New York: Churchill Livingstone, 2000. p.13-27.
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