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    Dr. Siswo Poerwanto MPH, MSC

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    Rama Bayu
    This document provides an overview of PICO and how it is used to formulate clinical questions. PICO breaks down clinical questions into four components: P) patient/problem, I) intervention, C) comparison, and O) outcome. It describes what each component represents and provides examples of how to construct a question using the PICO framework for different types of clinical questions, including those related to therapy/intervention, diagnosis/tests, etiology, and prognosis. Templates are given for formulating questions for each type.

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    Dr. Siswo Poerwanto MPH, MSC

    Uploaded by

    Rama Bayu
    41 views25 pages
    This document provides an overview of PICO and how it is used to formulate clinical questions. PICO breaks down clinical questions into four components: P) patient/problem, I) intervention, C) comparison, and O) outcome. It describes what each component represents and provides examples of how to construct a question using the PICO framework for different types of clinical questions, including those related to therapy/intervention, diagnosis/tests, etiology, and prognosis. Templates are given for formulating questions for each type.

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    MATERI 2 (PICO)

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    This document provides an overview of PICO and how it is used to formulate clinical questions. PICO breaks down clinical questions into four components: P) patient/problem, I) intervention, C) comparison, and O) outcome. It describes what each component represents and provides examples of how to construct a question using the PICO framework for different types of clinical questions, including those related to therapy/intervention, diagnosis/tests, etiology, and prognosis. Templates are given for formulating questions for each type.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    41 views25 pages

    Dr. Siswo Poerwanto MPH, MSC

    Uploaded by

    Rama Bayu
    This document provides an overview of PICO and how it is used to formulate clinical questions. PICO breaks down clinical questions into four components: P) patient/problem, I) intervention, C) comparison, and O) outcome. It describes what each component represents and provides examples of how to construct a question using the PICO framework for different types of clinical questions, including those related to therapy/intervention, diagnosis/tests, etiology, and prognosis. Templates are given for formulating questions for each type.

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    PICO

    DR. Siswo Poerwanto MPH, MSc


    Review: Five Steps of EBM
    • 1. convert information need into answerable
    questions.
    • 2. track down the best evidence to answer the
    question (with maximum efficiency).
    • 3. critically appraise the evidence for its validity
    and usefulness.
    • 4. integrate appraisal results with clinical
    expertise and patient values.
    • 5. evaluate outcomes (summary)
    PICO/PECO
    Formulating and articulating focused, answerable clinical
    questions
    P= Patient or Problem (or disease of interest)
    - Age
    - Gender
    - Ethnicity
    - With a certain disorder
    I=Invervention (or range of interventions of interest)
    - exposure to disease
    - prognostic factor A
    - risk behavior (e.g. smoking)
    PICO
    • C=Comparison (what you want to compare the
    interventions against)
    – - no disease
    – - placebo or no intervention/therapy
    – - prognostic factor B
    – - absence of risk factor (e.g. non-smoking)
    • O=Outcome
    – - risk of disease
    – - accuracy of diagnosis
    – - rate of occurrence of adverse outcome (e.g. death)
    PICO DOMAIN
    THERAPY/INTERVENTION

    DIAGNOSIS or DIAGNOSTIC TEST

    ETIOLOGY

    PROGNOSIS
    Intervensi
    • INTERVENTIONS cover a wide range of
    activities from drug treatments and other
    clinical therapies, to lifestyle changes (e.g. diet
    or exercise) and social activities (e.g. an
    education program). Interventions can include
    individual patient care or population health
    activities (e.g. screening for diseases such as
    cervical or prostate cancer).
    Contoh Skenario Klinis
    • A 28-year-old male presents with recurrent
    furunculosis (skin boils) for past 8 months; these
    episodes have been treated with drainage and
    several courses of antibiotics but keep recurring. He
    asks if recurrences can be prevented. To convert this
    to an answerable question, use the P I C O method
    • Question:
    • ‘In patients with recurrent furunculosis (skin boils), do
    prophylactic antibiotics, compared to no treatment,
    reduce the recurrence rate?’
    THERAPY/INTERVENTION:
    Question Template
    Pada (P)_________, apakah pengaruh
    (I)__________ dibandingkan dengan (C)
    ___________terhadap (O) _____________ ?
    Contoh:
    ‘In patients with recurrent furunculosis (skin boils) (P),
    do prophylactic antibiotics (I), compared to no treatment
    (C) , reduce the recurrence rate (O)?’
    ISILAH PICO
    • P =
    • I =
    • C =
    • O =
    Diagnosis
    • Diagnosis questions are concerned with how
    accurate a diagnostic test is in various patient
    groups, and in comparison to other available
    tests. Measures of test accuracy include its
    sensitivity and specificity.
    Situasi klinis
    • Julie is pregnant for the second time. She had her first
    baby when she was 33 and had amniocentesis to find out
    if the baby had Down's Syndrome. The test was negative
    but it was not a good experience as she did not get the
    result until she was 18 weeks pregnant. She is now 35,
    one month pregnant and asks if she can have a test that
    would give her an earlier result. The local hospital offers
    serum biochemistry plus nuchal translucency ultrasound
    as a first trimester test for Down's Syndrome. You wonder
    if this is as reliable as conventional amniocentesis.
    Question
    • ‘For pregnant women, is nuchal
    translucency ultrasound plus serum
    biochemistry testing in the first trimester as
    accurate (ie with equal or better sensitivity
    and specificity) as conventional
    amniocentesis for diagnosing Down's
    Syndrome?’
    DIAGNOSIS or DIAGNOSTIC TEST:
    Question Template
    Pada (P)________apakah (D1) ________ sama atau
    lebih akurat didalam mendiagnosa (O) ________
    dibandingkan dengan (D2 ) _______________?
    Contoh:
    ‘For pregnant women (P), is nuchal translucency
    ultrasound plus serum biochemistry testing (D1)in the
    first trimester as accurate (equal/better sensitivity &
    specificity) as conventional amniocentesis (D2) for
    diagnosing Down's Syndrome (O)?’
    ISILAH PICO
    • P =
    • I =
    • C =
    • O =
    Etiologi/Harm
    • AETIOLOGY and RISK FACTORS relate to questions
    that probe possible causes of a disease or illness.
    They are the reverse of intervention questions
    because they deal with the harmful outcomes of an
    activity or exposure. Such questions commonly
    arise in relation to public health issues, such as
    whether eating certain foods increases the risk of
    heart disease, or being exposed to an
    environmental chemical increases the risk of cancer,
    and so on.
    Situasi klinik
    • George wants to discuss the possibility of
    a vasectomy. He says he has heard
    something about vasectomy causing an
    increase in testicular cancer later in life.
    You know that the risk of this is low but
    want to give him a more precise answer.
    Question
    • ‘In men, does having a vasectomy
    (compared to not having one) increase the
    risk of getting testicular cancer in the
    future?’
    ETIOLOGY
    Apakah (P)__________ yang mempunyai
    (I)________ beresiko terhadap (O)___________
    dibandingkan dengan (P ) ________ yang tidak
    mempunyai (C ) _______________?
    Contoh:
    ‘In men (P), does having a vasectomy (I) increase the risk
    of getting testicular cancer in the future, compared to
    those not having vasectomy (C ) ?’
    ISILAH PICO
    • P =
    • I =
    • C =
    • O =
    Prognosis
    • Questions of FREQUENCY (prevalence ) are
    about how many people in the population
    have a disease or health problem, such as
    what is the frequency of hearing problems in
    infants or the prevalence of Alzheimer’s
    disease in the over 70s. If the question also
    includes a time period, such as for cases of
    influenza in winter versus summer, it becomes
    a question of rate (incidence).
    Situasi klinis
    • Example:
    • Mabel is a 6-week-old baby at her routine
    follow-up. She was born prematurely at 35
    weeks. You want to tell the parents about
    her chances of developing hearing
    problems
    Question
    • ‘In infants born prematurely, compared to
    those born at full term, what is the
    subsequent lifetime prevalence of sensory
    deafness?'
    PROGNOSIS
    Apakah pada (P1)______dibanding dengan (P2 )
    _______, apakah kemungkinannya mempunyai (O)
    __________?
    Contoh:
    ‘In infants born prematurely (P), compared to those
    born at full term (C ), what is the subsequent lifetime
    prevalence of sensory deafness (O)?'
    ISILAH PICO
    • P =
    • I =
    • C =
    • O =
    TUGAS KELOMPOK
    • 1. ISILAH FORMAT PICO DIATAS
    • 2. CARILAH SKENARIO KLINIS PADA PASIEN YG DIHADAPI OLEH
    FISIOTERAPIS, YANG MEMERLUKAN INTERVENSI BERUPA:
    2.A. THERAPY/INTERVENTION
    2.B. DIAGNOSIS or DIAGNOSTIC TEST
    2.C. ETIOLOGY
    2.D. PROGNOSIS
    • 3. RUMUSKAN MASING-MASING SITUASI DI 2A, 2B, 2C & 2D
    DENGAN PERTANYAAN SESUAI TEMPLATE PICO YANG BENAR.
    • 4. SAJIKAN DENGAN PPT, PER KELOMPOK, MULAI 2 FEBRUARI 2021
    • 5. KELENGKAPAN & KEBENARAN PELAPORAN AKAN MEMBERI NILAI
    INDIVIDU (TERGANTUNG KONTRIBUSI & KEAKTIFAN)

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