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Posted: September 6th, 2023

The Well-Built Clinical Question:

Formulate a PICOT Question
The objective of this discussion is to introduce students to Evidence-Based Practice by teaching them to pose specific questions of importance for their practice. Therefore, for this discussion, you will be developing and writing your own clinical-oriented (PICO(T)) questions as discussed in the learning module.
Instructions:
1. Instructions:
1. Questions are the driving force behind EBP. If there were no questions, EBP would be unnecessary. Using the identified clinical problem in discussion #2.
2. Formulate a PICOT question by identifying:
A. P – Patient or Problem: Who is the patient? What are the most important characteristics of the patient? What is the primary problem, disease, or co-existing condition?
B. I – Intervention: What is the main intervention being considered?
C. C – Comparison: What is the main comparison intervention? (optional)
D. O – Outcome: What are the anticipated measures, improvements, or effects?
3. Convert this PICOT to a clinical question.
4. indicate the best study method to answer this PICOT question (use the PICOT worksheet
4. Download PICOT worksheet and attached to this discussion post).
5. Title the discussion with the PICOT question.
6. Initial post: Your post should be within a range of 150-240 words.
7. Peer response: Identify two (2) students that may share a similar question and invite them to discuss the topic (be engaging, these classmates may become your group partners for the EBP project).
8. Cite your references APA 7th ed. (not included in the length of the post).
9. To see rubric, click on the 3-dot menu on the top-right side of screen.
To begin the discussion, click on the “Reply” button below.

The Well-Built Clinical Question
PICO Worksheet

INSTRUCTIONS:
Think about a complex clinical problem that you encountered in your daily practice. Use the following table to identify the patient/population, intervention, comparison, and outcomes. Once is done try to formulate your question.

Question Components
Your QuestionP – Patient or Population

Describe the most important characteristics of the patient.
(e.g., age, disease/condition, gender)
I – Intervention; Prognostic Factor; Exposure

Describe the main intervention.
(e.g., drug or other treatment, diagnostic/screening test)
C – Comparison (if appropriate)

Describe the main alternative being considered.
(e.g., placebo, standard therapy, no treatment, the gold standard)
O – Outcome

Describe what you’re trying to accomplish, measure, improve, affect.
(e.g., reduced mortality or morbidity, improved memory, accurate and timely diagnosis)
The well-built clinical question:

INSTRUCTIONS: Fill in the blanks with information from your clinical scenario:

THERAPY
In_______________, what is the effect of ________________on _______________ compared with _________________?

PREVENTION
For ___________ does the use of _________________ reduce the future risk of ____________ compared with ______________?

DIAGNOSIS OR DIAGNOSTIC TEST
Are (Is) ________________ more accurate in diagnosing _______________ compared with ____________?

PROGNOSIS
Does ____________ influence ______________ in patients who have _____________?

ETIOLOGY
Are ______________ who have _______________ at ______________ risk for/of ____________ compared with _____________
with/without______________?

MEANING
How do _______________ diagnosed with _______________ perceive __________________?
INSTRUCTIONS: Scenario (check all that apply):

Type of QuestionIdeal Type of Study TherapyRCT PreventionRCT > Cohort Study > Case Control DiagnosisProspective, blind controlled trial comparison to gold standard PrognosisCohort Study > Case Control > Case Series/Case Report Etiology/HarmRCT > Cohort Study > Case Control Cost analysiseconomic analysisNote: Meta-analyses and systematic reviews, when available, often provide the best answers to clinical questions.

INSTRUCTIONS:

 OR 

AND Main Concepts (PICO concepts)MeSH/Subject HeadingsSynonyms

Search Strategy Development

INSTRUCTIONS: Finding the right words to get what you want. From your PICO, fill in as much as you can of the table below.

Primary search termSynonym 1Synonym 2P
I
C
O

INSTRUCTIONS: List your inclusion criteria –i.e. gender, age, years of publication

________________________________________
________________________________________
________________________________________
________________________________________
INSTRUCTIONS: Check any limit that may pertain to your search:

_____ Age ___________________ Language __________ Year of publication

Type of study/publication you want to include in your search: (From Step 2 of tutorial)

__ Systematic Review or Meta-Analysis
__ Clinical Practice Guidelines
__ Critically Appraised Research Studies __ Individual Research Studies
__ Electronic Textbooks
Check the databases you searched:
__ Cochrane Library
__ Joanna Briggs
__ CINAHL with Full Text
__ PubMed Clinical Queries
What information did you find to help answer your question?

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The Well-Built Clinical Question:

P – Patient or Population: Patients with Type 2 diabetes mellitus and obesity.
I – Intervention: Intensive lifestyle intervention (including diet and exercise).
C – Comparison: Standard care (including medication management and routine lifestyle advice).
O – Outcome: Weight loss and glycemic control.

The well-built clinical question:
In patients with Type 2 diabetes mellitus and obesity, what is the effect of intensive lifestyle intervention (including diet and exercise) on weight loss and glycemic control compared with standard care (including medication management and routine lifestyle advice)?

Type of Question: Therapy
Ideal Type of Study: Randomized Controlled Trial (RCT)

Search Strategy Development:
Primary search term: Type 2 diabetes mellitus AND obesity AND intensive lifestyle intervention AND weight loss AND glycemic control
Synonym 1: T2DM AND overweight AND lifestyle modification AND reduction in body weight AND blood glucose management
Synonym 2: Non-insulin dependent diabetes AND obesity AND behavior modification AND decrease in BMI AND glycemic regulation

Inclusion criteria: Adults with Type 2 diabetes mellitus and obesity, published within the last 10 years.

Limits: Age: Adults (18 years and older), Language: English, Year of publication: 2013-2023

Databases searched: PubMed, Cochrane Library, CINAHL with Full Text

Information found to help answer the question:
The search yielded several relevant studies comparing intensive lifestyle intervention with standard care in patients with Type 2 diabetes and obesity. These studies reported significant improvements in weight loss and glycemic control with intensive lifestyle intervention compared to standard care. The results were consistent across different populations and settings, supporting the effectiveness of lifestyle interventions as an adjunct to medication management in the management of Type 2 diabetes and obesity.

References:
(Provide relevant references here, using APA 7th ed. citation format)

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