1. How to formulate an answerable research question? Using the PICO model to formulate a search question

2. Hierarchy of Evidence

5. Why are research questions important? “Well-crafted questions guide the systematic planning of research. Formulating your questions precisely enables you to design a study with a good chance of answering them.” -- Light, Singer, Willett, By Design (1990)

6. Start at the beginning A good research project generally begins in the mind of the doctor. Most research questions are too broad at first. The narrower the focus, the easier the question is to research.

7. An example of a research question … “What is the usefulness or accuracy of the current 1-10 pain scale assessment in treating a patient’s pain, and what are other options that may prove more useful?” Is this question researchable?

8. Characteristics of a Good Study Question “FINER” F= Feasible I= Interesting N= Novel E= Ethical R= Relevant

9. Asking “the Question” The PICO format: P Population I Intervention or Interest area C Comparison intervention or status O Outcome

10. What is PICO? A useful model to help structure an answerable question Used to formulate clinical questions Breaks down the question into four key elements

12. Patient, Population, Problem Patient or patient group (gender, race, age) Disease or condition Stage of the illness Care setting

13. Intervention Type of treatment (drug, procedure, therapy) Intervention level (dosage, frequency) Stage of intervention (preventative, early, advanced) Delivery (who delivers the intervention? where?)

14. Comparison Alternative interventions (standard treatment, placebo, another intervention) There may not always be a comparison

15. Outcome The outcome or effects you are interested in, for example Improvement of symptoms, healing Side effects Improved quality of life Cost effectiveness and benefits for the service provider

16. Remember… Including more search terms will narrow your search Use for very specific questions and larger databases to make number of results more manageable For a broader search, less specific details are needed Use for broader questions and smaller databases which bring back fewer results

17. A good research question will… be clearly linked to overall project goal allow the target population to be identified guide the appropriate choice of study subjects

18. A good research question will… identify the outcome variables and key predictors of those variables determine what type of study is needed (e.g. descriptive, relational, experimental) identify background characteristics that might influence outcomes

19. A good research question will… raise questions about how to best collect data influence the number of participants in the study

21. Is it researchable?

22. Is it significant?

24. Identifying the key concepts Example search scenario: What evidence is there to support “honey” therapy for the treatment of neck wound dehiscense rather than conventional debridement therapies? What evidence is there to support “honey” therapy for the treatment of neck wound dehiscenserather than conventional debridement therapies?

25. Using the PICO model P Neck wound dehiscence(problem) IHoney therapy (proposed intervention) C Conventional debridement therapies (comparative treatment) O Wound healing (outcome)

26. How to formulate an answerable research question? Using the PICO model to formulate a search question