Evidence-based Research

Search using PICO: this is a template to formulate a clinical question

• Patient, Population or Problem
  • What are the characteristics of the patient or population?
  • What is the condition or disease you are interested in?
• Intervention or exposure
  • What do you want to do with this patient (e.g. treat, diagnose, observe)?
• Comparison
  • What is the alternative to the intervention (e.g. placebo, different drug, surgery)?
• Outcome
  • What are the relevant outcomes (e.g. morbidity, death, complications)?
• T is sometimes included, but it can mean Time, Type of study, or Type of question

• Asking the Well Built Clinical Question  a classic from ACP Journal Club
• Finding the Evidence 1 – Using PICO to formulate a search question  Centre for Evidence-Based Medicine 
• PICO video https://youtu.be/rXQQsFeRLz0

Determine inclusion/exclusion criteria before searching.  What kind of studies will be included? What kind of studies will be excluded? Some examples are:

• Date of publication (5 years, 10 years, unlimited)
• Language of publication
• Methodology, quantitative or qualitative or mixed method
  • Randomized controlled trials only
  • Other: cohort, case-control
  • Qualitative: Interviews, focus groups, ethnography
• Age of subjects
• Gender
• Ethnicity
• Socioeconomic level

Joanna Briggs Manual for Evidence Synthesis; Chapter 3.2.4 Inclusion Criteria

Cochrane Handbook for Systematic reviews of Interventions; Part 2,  Chapter 3  Defining the criteria for including studies

Protocol tools to help develop the steps:

• PRISMA Checklist
• AMSTAR Checklist

• PRISMA   Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA, is a statement paper designed primarily for systematic reviews of studies that evaluate the effects of health interventions, irrespective of the design of the included studies. It is an evidence-based minimum set of items for reporting in systematic reviews and meta-analyses and includes a checklist and flow diagram for planning a systematic review. 
• Several extensions to PRISMA have been developed to cover aspects of reporting not captured in the main 2020 Statement. These extensions provide reporting guidance for reviews that, for example, address particular review questions (e.g. diagnostic test accuracy), or use particular data sources (e.g. individual participant data
• PRISMA for Scoping Reviews is a checklist which contains 20 essential reporting items and 2 optional items to include when completing a scoping review.
• PRISMA Checklist 27-item checklist addressing the introduction, methods, results and discussion sections of a systematic review report.
• The 2020 PRISMA Flow Diagram