A comparison of patient, intervention, comparison, outcome (PICO) to a new, alternative clinical question framework for search skills, search results, and self-efficacy: a randomized controlled trial

Abstract

Objective: In educating students in the health professions about evidence-based practice, instructors and librarians typically use the patient, intervention, comparison, outcome (PICO) framework for asking clinical questions. A recent study proposed an alternative framework for the rehabilitation professions. The present study investigated the effectiveness of teaching the alternative framework in an educational setting.Methods: A randomized controlled trial was conducted with students in occupational therapy (OT) and physical therapy (PT) to determine if the alternative framework for asking clinical questions was effective for identifying information needs and searching the literature. Participants were randomly allocated to a control or experimental group to receive ninety minutes of information literacy instruction from a librarian about formulating clinical questions and searching the literature using MEDLINE. The control group received instruction that included the PICO question framework, and the experimental group received instruction that included the alternative framework.Results: There were no significant differences in search performance or search skills (strategy and clinical question formulation) between the two groups. Both the control and experimental groups demonstrated a modest but significant increase in information literacy self-efficacy after the instruction; however, there was no difference between the two groups.Conclusion: When taught in an information literacy session, the new, alternative framework is as effective as PICO when assessing OT and PT students’ searching skills. Librarian-led workshops using either question formulation framework led to an increase in information literacy self-efficacy post-instruction.

Research Questions with PICO: A Universal Mnemonic

“…Such a metadata scheme could also help with building better search engines that allow for a more precise discovery of scholarly works, such as based on a given method or theory or research goal, something that already exists for the clinical literature at the PubMed PICO Tool [46,47] but which could be broadened to other disciplines as well. This implementation would thus come close to the original intention of the mnemonic as a tool for research discovery [48] and literature search, rather than just for the formulation of research questions [11,36,49]. In addition, the aggregate patterns of such metadata could also provide insights into the prevalence (or absence) of explicit control groups in specific disciplines.…”

“…The pedagogical effect, however, remains to be empirically tested. It is yet unknown whether this version of PICO helps students to be more efficient with focused research projects (albeit there are promising results with regards the use of PICO in literature searches [35,36]), and it still remains hypothetical whether compliance with PICO is really "associated with a higher quality of research reporting" [37]. What this paper did was merely suggest that PICO can be useful for noncorrelational, nonclinical studies, with possible implications for the teaching of academic writing.…”

Effectiveness of eHealth Self-management Interventions in Patients With Heart Failure: Systematic Review and Meta-analysis

“…Inclusion and exclusion criteria strictly followed the Participants-Intervention-Comparison-Outcome (PICO) framework [ 29 ]: (1) participants were defined as adults (aged≥18 years) who had been diagnosed with HF (studies in children or adolescents were excluded); (2) interventions consisted of self-management tools including at least one eHealth component (eg, mobile apps), with traditional interventions that did not use any technical support excluded, such as face-to-face meetings; (3) the comparison was HF patients versus usual care; and the (4) outcomes included patient and process outcomes. Patient outcomes are measures directly related to the disease and were considered as the primary outcomes in our study, including all-cause readmission rate, all-cause mortality, HF readmission, and cardiovascular mortality.…”

“…Inclusion and exclusion criteria strictly followed the Participants-Intervention-Comparison-Outcome (PICO) framework [29]: (1) participants were defined as adults (aged≥18 years) who had been diagnosed with HF (studies in children or adolescents were excluded); (2) interventions consisted of self-management tools including at least one eHealth component (eg, mobile apps), with traditional interventions that did not use any technical support excluded, such as face-to-face meetings;…”

The effectiveness of eHealth self-management interventions in patients with chronic heart failure: Protocol for a systematic review and meta-analysis

“…Inclusion and Exclusion Criteria are followed the Participants-Intervention-Comparison-Outcome (PICO) framework (see Table 1 ) [ 27 ]. We will only include peer reviewed the paper in English with no publication time restriction.…”