14. PICO QUESTIONS
According to the Centre for Evidence Based Medicine (CEBM), “one of the fundamental skills required for practising EBM is the asking of well-built clinical questions. To benefit patients and clinicians, such questions need to be both directly relevant to patients’ problems and phrased in ways that direct your search to relevant and precise answers.”
A well-built clinical foreground question should have 4 components. The PICO model is a helpful tool that assists in organising and focusing the foreground question into a searchable query. Divided into the PICO elements helps identify search terms/concepts to use in your search of the literature.
- P = Patient, Problem, Population (How would you describe a group of patients similar to you? What are the most important characteristics of the patient?)
- I = Intervention, Prognostic Factor, Exposure (What main intervention are you considering? What do you want to do with this patient? What is the main alternative being considered?)
- C = Comparison (Can be None or placebo.) (What is the main alternative to compare with the intervention? Are you trying to decide between two drugs, a drug and no medication or placebo, or two diagnostic tests?)
- O = Outcome (What are you trying to accomplish, measure, improve or affect? Outcomes may be disease-oriented or patient-oriented.) [61]
PICO for “Catheterisation - male external catheters in adults” guidelines
| Topic | |
| Population Condition, disease severity and stage, comorbidities & patient demographics | Men with urinary incontinence |
| Intervention Dosage, frequency and method of administration | Use of a male external catheter |
| Comparator Placebo, usual care or active control | Use of pads or naps or being incontinent or use of an indwelling catheter or use of an intermittent catheter |
| Outcome Health outcomes: morbidity, mortality, quality of life. | Urinary symptoms / quality of life / incontinence, urinary complications such as UTI, allergic reactions |
PICO 1
Are there any advantages or disadvantages compared to other continence devices in treating incontinence with male external catheters?
PICO 2
Are there factors in product quality / material aspects that predict a better outcome in
- handling the products
- complications
- incontinence accidents
- skin condition
PICO 3
Is there any evidence that nurse education influences the results or prevents complications in males with MEC
PICO 4
Which issues have to be considered before fitting MEC to get the best results in continence and prevent complications?
PICO 5
Is there any evidence on using MEC related to the prevention of pressure sores, skin lesions/allergies or leakage
PICO 6
Is there any evidence on MEC compared to other catheters or on special nursing interventions to prevent urinary tract infections