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Doctor of Physical Therapy Research Methods DPT 605

Evidence Based Practice using PICO and CAT

Introduction

Incorporating evidence into clinical practice involves 5 steps: 

(1) PICO - developing patient-oriented clinical question,
(2) Efficiently searching the professional literature for best evidence to answer the question, 
(3) CAT -  Critically appraising that evidence for validity, impact, and applicability, summary of your search in answering           the clinical question of interest based upon the best available evidence.
(4) integrating that evidence with provider expertise and the patient’s values
(5) evaluating the effectiveness and efficiency of the process
 
Tools

Step One: PICO

Use PICO to develop a clinically relevant, answerable question:

P = Population/Problem 

I  = Intervention

C = Comparator/Control 

O = Outcome

 

Step Two: Best Evidence

Now that you've created your clinical question, you should begin tracking down the best evidence.  Using your PICO terms as the keywords in your search will help bring results specific to your topic. Be sure to keep the following in mind:

           - Be aware of the type of study or design of the study that you're looking at.

            -Be aware of the levels of evidence available.

            -Don't forget to cite your sources/create a bibliography as you go.

Suggested Databases below :

Step Three: CAT - Evaluate Evidence

- Is it close enough to your PICO?

- What kind of article is it?

- What kind of research by who and was it done well?

Cite your research

Resources for your appraisal:

Study Design 101 - An understanding of different types of clinical medical studies 

Critical Appraisal Tools - guides for critical appraisal used in the systematic evaluation of clinical research. 

Critical Appraisal of a Journal Article - Examples of different types of articles.

Step Four: Integration

Step Five: Clinical Bottom Line

Clinical bottom line is the recommendations based on the literature! 

The summary of the best evidence gives you a clinical bottom line. 

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