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Movement Science: Evidence Based Research (PICO)

Evidence Based Medicine

EBM is "the conscientious use of current best evidence in making clinical decisions about patient care". This original definition is attributed to this article by Sackett, et al.

What is Evidence Based Practice?

EBP is a method of effectively translating EBM into clinical practice using the best existing: evidence and research, knowledge of clinical experts, and patient preferences.

Evidence Pyramid

This Evidence Hierarchy Pyramid is often used to graphically represent the quality of medical research. The higher on the pyramid the more comprehensive in scope, and more rigorous the methodology and peer review. You should be looking for the highest level of research available in EBP.

This guide will help you locate the highest levels of evidence: systematic reviews & meta-analyses, and practice guidelines. 

If you can't locate the highest levels of research to answer a specific clinical question you should use the highest level available.  Look for tutorials on searching reliable sources such as CINAHL, Medline, and PubMed databases for articles, studies and reports.

For definitions of terms used above, see: Evidence Based Study Definitions

Step One: Ask a Clinical Question

Using the PICO format can be instructive!

Patient Population
Comparison Intervention

Types of Questions: Etiology, Diagnostic, Prevention, Prognosis/Prediction, Therapy, Qualitative

Prevention Example:
For patients with systolic heart failure (P) do exercise programs (I) reduce the future risk of hospital admission due to heart failure (O) compared with patients without exercise programs (C)?
Therapy Example:
In patients with chronic wounds (P) what is the effect of topical negative pressure (TNP) (I) on promoting healing (O) compared with traditional moisturized gauze (C) dressing?

Steps Two through Five

Step Two: Acquire the most relevant, most current, best evidence. See Evidence Hierarchy

Step Three: Appraise the evidence.

Step Four: Apply all evidence with clincial experience, patient preferences and values in making a practice decision or change.

Step FiveAccess the practice decision or change.

PICO Continued

Etiology: Are ____(P), who have ____ (I) at ____(increased/decreased)risk for/of_____(O) compared with____(P) with/without_____(C)?

Diagnostic: Are(Is)____(I) done on _____(P)more accurate in diagnosis of _____(O)compared to ______(C)?

Qualitative: How do ____ (P), perceive the  ____ (I) on ____ (O) compared to _____ (C)?

Prognosis/Prediction: Does ____ (I) influence ____ (O) in patients who have ____ (P)?

TRIP Database PICO Wizard:
You may find this helpful.  Click on the PICO Search button for help building a PICO question.

More Information - EBP Tutorial

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