Zusammenfassung der Ressource
Steps of critical appraisal and PICO
- process of critical appraisal requires us to review all the above aspects
of validity (internal and external) as well as the issue of reliability
- steps below show an example of the critical appraisal process, which is the core part of
EBP:
- 1.We start with a clinical question or problem about some real clinical issue that we need to answer.
- 2.The question is then put into what is called a PICO format (see box below for
details).
- 3.The PICO helps us to clarify the issues to be reviewed and develop
the correct search strategies to find the literature by using the
relevant library databases
- 4.Once we have completed our literature search and found the best
study to review, we can use the steps for critical appraisal to check
its internal and external validity.
- 5. final step is the clinician's overview of all the evidence from
the literature search, but now includes his/her clinical
experience plus what the patient/client brings to the clinical
relationship
- e.g. patient does not want to take NSAIDs for
her arthritis).
- steps or questions we use for critical appraisal will differ depending
on what type of study design was used in each of the articles we
find in the literature search
- I might be nursing a patient who asks me 'Is glucosamine better
that non-steroid anti-inflammatory drugs (NSAIDs) in treating
arthritis in women like me (>50 years)?'
- PICO
- Population
- the population or patient group you are interested in.
- t might be women aged 50 years and over living in rural
areas.
- Intervention
- relates to the treatment terms or phrases in your question
- does a specific drug or type of occupational therapy intervention work?
- Comparsion
- relates to alternative treatment that you might want to compare
the current intervention with (if this is appropriate to your
question).
- the comparison could be another drug or a placebo
- Outcome
- is about what you trying to accomplish, measure, improve
or affect for your clinical problem or patient.
- improved mobility in women with arthritis.
- E.g of PICO
- P
- Pregnant women with type 2 diabetes.
- I
- Insulin pump therapy.
- C
- Conventional insulin therapy.
- O
- Improved management of blood glucose levels.
- The prob
- A pregnant woman with type 2 diabetes is concerned about the
effect that her current treatment may have on her pregnancy and
unborn child. Her GP has heard that insulin pump therapy may be a
more successful treatment than conventional insulin therapy.
However, the GP wants to get his facts right, so searches the
literature.
- The Question
- 'Are insulin pumps more effective than conventional therapies in
managing type 2 diabetes in pregnant women?'