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Palliative Care Information Resources

Introduction

Formulating a specific clinical question is the first step of practicing evidence-based medicine.

The five steps of evidence-based medicine:

  1. Formulate the question
  2. Search for the evidence
  3. Appraise the evidence
  4. Apply the results
  5. Evaluate the process

Developing Your Clinical Question

Why should I formulate a structured research question?

  • To identify the key/main concepts for your literature search strategy
  • To improve your literature search information retrieval
  • To give you a way of evaluating answers

What characterizes a good question?

  • Well-developed
  • Relevant
  • Direct and clear
  • Focused

What does an undeveloped question look like?

  • "What is the impact of palliative care in patients with cancer?”

What does a well-formulated question look like?

  • "What is the impact of integrating palliative care into the treatment plan for hospitalized patients with advanced cancer?"

Frameworks for Formulating Questions

Applying a framework when developing a research question can help to identify the key concepts and determine inclusion and exclusion criteria.

PICo: Population /types of Participants, phenomenon of Interest, Context

PICO(S):        

Patient/Problem, Intervention, Comparator/Control, Outcome, (Study design)

PECO:       

Patient/Problem, Exposure, Comparison/Control, Outcome

PESICO:    

Person, Environment, Stakeholders, Intervention, Comparison, Outcome

PIPOH:       

Population, Interventions, Professionals/Patients, Outcome, Healthcare Setting

 

Example: PICO Question

P (Patient, Population, Problem) I (Intervention) C (Comparator) O (Outcome)
How would I describe a group of patients similar to mine?  What main interventions, prognostic factors or exposure are you considering? What is the main alternative to compare with the intervention?  What can you hope to accomplish, measure, improve or effect?

In:

Children with life-threatening cancer...

Does:

specialty pediatric palliative care...

Versus:

usual care (no specialty pediatric palliative care)...

Result in:

improved outcomes for children with cancer and their families?