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William Osler Health System - Resources for Evidence Based Practice: Forming Questions

Evidence-Based Practice Resources


The five steps of EBP

 Evidence-based practice consists of five steps:
  1. Ask a searchable clinical question
  2. Find the best evidence to answer the question
  3. Appraise the evidence
  4. Apply the evidence with clinical expertise taking the patient's wants / needs into consideration
  5. Evaluate the effectiveness and efficiency of the process

Source: Strauss, S. E.  Evidence-Based Medicine: How to Practice and Teach EBM. New York: Churchill Livingstone, 2005.

Forming question

How to Look?
  •  Start with focused topic
  •  Develop your PICO that helps you build a search strategy by clearly identifying all parts of the clinical question.

PICO - a method of putting together a search strategy that allows you to take a more evidence based approach to literature searching when searching bibliographic databases.

P is for the Patient or the Problem (e.g. a disease or condition) or Population of interest - who or what?               

is for Intervention (e.g. therapy, procedure, drug, exposure, test, strategy) or indication - how?                                  

C is for Comparison (e.g. compared to an alternative intervention or an experimental control - what is the main alternative?             

O is for Outcome (i.e.the consequence, effect or improvement of interest) - what are you trying to accomplish, measure, improve, effect?

P Population / Patient / Problem
I Intervention
C Comparison
O Outcome
  • Identify subject heading / keywords you want to search and plan how you are going to connect the terms
  •  Search each keywords / subjects separately
  • Use filters and limits to narrow / refine your search - population characteristics: age or gender; publication descriptors:date or language

Search Process Diagram

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