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      The PICO strategy for the research question construction and evidence search Translated title: A estratégia PICO para a construção da pergunta de pesquisa e busca de evidências Translated title: Estrategia PICO para la construcción de la pregunta de investigación y la búsqueda de evidencias

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          Abstract

          Evidence based practice is the use of the best scientific evidence to support the clinical decision making. The identification of the best evidence requires the construction of an appropriate research question and review of the literature. This article describes the use of the PICO strategy for the construction of the research question and bibliographical search.

          Translated abstract

          Prática baseada em evidências é a utilização da melhor evidência científica para subsidiar a tomada de decisão clínica. Identificar a melhor evidência requer adequada construção da pergunta de pesquisa e de revisão da literatura e este artigo descreve o uso da estratégia PICO para a construção da pergunta de pesquisa e busca bibliográfica.

          Translated abstract

          La práctica basada en evidencias permite la elección de la mejor evidencia científica para subsidiar la toma de decisión clínica. Para lo cual, se requiere de una adecuada construcción de la pregunta de investigación y de la revisión de la literatura. Este artículo describe el uso de la estrategia PICO para la construcción de la pregunta de investigación y la búsqueda bibliográfica.

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          Evidence-based medicine.

          Evidence-based medicine, whose philosophical origins extend back to mid-19th century Paris and earlier, is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. By individual clinical expertise we mean the proficiency and judgment that we individual clinicians acquire through clinical experience and clinical practice. Increased expertise is reflected in many ways, but especially in more effective and efficient diagnosis and in the more thoughtful identification and compassionate use of individual patients' predicaments, rights, and preferences in making clinical decisions about their care. By best available external clinical evidence we mean clinically relevant research, often from the basic sciences of medicine, but especially from patient centered clinical research into the accuracy and precision of diagnostic tests (including the clinical examination), the power of prognostic markers, and the efficacy and safety of therapeutic, rehabilitative, and preventive regimens. External clinical evidence both invalidates previously accepted diagnostic tests and treatment and replaces them with new ones that are more powerful, more accurate, more efficacious, and safer. Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming tyrannized by external evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. Without current best external evidence, practice risks becoming rapidly out of date, to the detriment of patients. The practice of evidence-based medicine is a process of life-long, self-directed learning in which caring for our own patients creates the need for clinically important information about diagnosis, prognosis, therapy, and other clinical and health care issues, and in which we (1) convert these information needs into answerable questions; (2) track down, with maximum efficiency, the best evidence with which to answer them (whether from the clinical examination, the diagnostic laboratory from research evidence, or other sources); (3) critically appraise that evidence for its validity (closeness to the truth) and usefulness (clinical applicability); (4) integrate this appraisal with our clinical expertise and apply it in practice; and (5) evaluate our performance.
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            Popping the (PICO) question in research and evidence-based practice.

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              Systematic reviews: the heart of evidence-based practice.

              K Stevens (2001)
              Research utilization approaches in nursing recently have been replaced by evidence-based practice (EBP) approaches. The heart of the new EBP paradigm is the systematic review. Systematic reviews are carefully synthesized research evidence designed to answer focused clinical questions. Systematic reviews (also known as evidence summaries and integrative reviews) implement recently developed scientific methods to summarize results from multiple research studies. Specific strategies are required for success in locating systematic reviews. Major sources of systematic reviews for use by advanced practice nurses in acute and critical care are the Online Journal of Knowledge Synthesis for Nursing, Agency for Healthcare Research and Quality, and the Cochrane Library. This discussion describes systematic reviews as the pivotal point in today's paradigm of EBP and guides the advanced practice nurse in locating and accessing systematic reviews for use in practice.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                rlae
                Revista Latino-Americana de Enfermagem
                Rev. Latino-Am. Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo (Ribeirão Preto )
                1518-8345
                June 2007
                : 15
                : 3
                : 508-511
                Affiliations
                [1 ] Hospital Alemão Oswaldo Cruz
                [2 ] Universidade de São Paulo Brazil
                [3 ] Universidade de São Paulo Brazil
                Article
                S0104-11692007000300023
                10.1590/S0104-11692007000300023
                17653438
                ad0ad004-5274-4bdd-af96-87d6c58a97f3

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0104-1169&lng=en
                Categories
                NURSING

                Nursing
                nursing,evidence-based medicine,nursing research,decision making,review literature,bibliographic databases,enfermagem,medicina baseada em evidências,pesquisa em enfermagem,tomada de decisões,literatura de revisão,bases de dados bibliográficas,enfermería,medicina basada en evidencia,investigácion en enfermaría,toma de decisiones,literatura de revisión,bases da datos bibliográficas

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