PICO ANALYSIS

QOESTION COMPONENTS
P-Patient or Population Describe the most important characteristics of the patient, (e.g. age, disease/condition, gender)

YOUR ANSWER

I-Intervention: Prognostic Factor; Exposure Describe the main intervention (e.g. drug or other treatment, diagnostic/screening test)

CHECKLIST
TYPE OF QUESTIONS Therapy IDEAL TYPE OF STUDY RCT

Prevention
Diagnosis Prognosis Etiology / Harm Cost Analysis

RCT>Cohort Study>Case Control

Prospective, blind controlled trial comparison to goal standard Cohort Study > Case Control > Case Series/Case Report RCT > Cohort Study > Case Control Economic Analysis

Note: Meta-analyses and systematic reviews, when available, often provide the best answer to clinical questions

C-Comparison (if appropriate) Describe the main alternative being considered (e.g. placebo, standard therapy, no treatment, the gold standard) O-outcome Describe what youre trying to accomplish, measure, improve, affect. (e.g, reduced mortality or morbidity, improved memory, accurate and timely diagnosis) Clinical question

 Pauline is a new patient who recently moved to the area to be closer to her son and his family. She is 67 years old and has a history of congestive heart failure brought on by several myocardial infarctions. She has been hospitalized twice within the last 6 months for worsening of heart failure. At the present time she remains in normal sinus rhythm. She is extremely diligent about taking her medications (enalapril, aspirin and simvastatin) and wants desperately to stay out of the hospital. She lives alone with several cats.You think she should also be taking digoxin but you are not certain if this will help keep her out of the hospital. You decide to research this question before her next visit. Pauline

 Patient / Problemcongestive heart failure, elderlyInterventiondigoxin Comparison, if anynone, placebo Outcomeprimary: reduce need for hospitalization; secondary: reduce mortality

 For our patient, the clinical question might be: In elderly patients with congestive heart failure, is digoxin effective in reducing the need for rehospitalization?

UNDERSTANDING CHECK LIST

What is the objective of the study? What is the design of the study? How many patients were included in the study? How many patients were included in the study? How are they grouped?

 What is the result of the study in term of mortality? How many death were found in digoxin group? What is the result of the study in term of hospitalization? How many hospitalizations were found in placebo group?

 What is the conclusion? What is the existing state of knowledge on digoxin? What is the gap in knowledge that the study will fill? What did the author intend to do? Where was the study conducted?