FRAMING RESEARCH QUESTIONS The PICO Strategy. PICO P: Population of interest I: Intervention C: Control O: Outcome

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Framing Research Questions

Framing Research QuestionsThe PICO StrategyPICOP: Population of interestI: InterventionC: ControlO: Outcome

PICOP: Population of interestPatient characteristics or the problem to be addressed

I: InterventionExposure to be consideredtreatments/ tests

C: ControlControl or comparison intervention treatment/placebo/standard of care

O: OutcomeOutcome of interest: what you are trying to measure, improve or affect; may be disease-oriented or patient oriented.

PICO- ControlsThe C, Controls, is the the only optional component in the PICO question.Can look at an intervention without exploring an alternative.May not be an alternative.What type of question is being asked?Therapy/ preventionDiagnosisEtiologyPrognosisWhat type of question is being asked?Therapy/ preventionQuestions of treatment in order to achieve an outcome

DiagnosisQuestions of identification of a disorder in a patient with specific symtoms.

Etiology/ HarmQuestions of negative impact from an intervention or exposure.

PrognosisQuestions of progression of a disease or the likelihood of a disease occurring.

How large was the treatment effect?Most RCTs look at a dichotomous outcome: (yes or no, did death occur or not, did a patient suffer an event or not?).

Can express impact of treatment as Relative Risk:

The risk of events among patients on the new treatment, relative to that risk among patients in the control group.Relative RiskIf RR=1 risk in treatment group (exposed) equals risk in non-treatment group (non-exposed).

If RR>1 risk in treatment group (exposed) is greater than in non- treatment group (non-exposed); positive association, possibly causal.

If RR0.10, the observed difference is not significant.

When 0.05< P< 0.10, the observed difference is said to be marginally significant.

When 0.01