PICO Question Patients problem Neck pain Low back

PICO Question

Patients problem • Neck pain • Low back pain • Supra spinatus tendinitis

Intervention or indicator • What is the management strategy or diagnostic test or exposure you are interested in(such as drug , food , surgical procedure , diagnostic test , or exposure to a chemical)

Comparator or control • Is there a control or alternative management strategy , test or exposure

outcome • What are patient’s relevant consequences of intervention

• Different types of questions • The most common type of clinical question is about how to treat a disease or condition. In Evidence Based Medicine (EBM), treatments and therapies are called ‘interventions’ and such questions are questions of INTERVENTION. • Not all research questions are about interventions. Other types of questions may arise:

• What causes the problem? AETIOLOGY, RISK FACTORS • What is the frequency of the problem? FREQUENCY • Does this person have the problem? DIAGNOSIS • Who will get the problem? PROGNOSIS, PREDICTION

• In each case the P I C O method can be used to formulate the question, as shown in the following examples. You can use the same approach to research qualitative questions about health issues of a more general nature (i. e. PHENOMENA). In this case, the question will consist of ‘P’ and ‘O’ only.

P I C O' examples • Interventions üTh Ex , manual therapy , electrophysiological modality, ü lifestyle changes (e. g. diet or exercise) üsocial activities (e. g. an education program). q Interventions can include individual patient care or population health activities (e. g. screening for diseases such as cervical or prostate cancer).

01 Mr A, software Eng is suffering from mild neck pain since 3 months on and off. Problem/pain increases with long hours of sitting. His physical therapist told him that this problem is due to poking chin(postural related) and can be relieved with HEP(home exercise programe). He wants to know whether this problem is curable with HEP Q: In patients with postural neck pain and no structural changes does HEP compared to no treatment will lead to complete pain relieve

• • P: patient with postural neck pain I : HEP C: no treatment/Ex O: complete relief in pain

02 • Mr b is a patient with shoulder pain since 1 month. He is a professional lawyer. problem started after an accidental fall. He is diagnosed with SS tendinitis. PT wants to know about laser therapy treatment option for early functional restoration • Q: In Patients with SS tendinitis (d/t traumatic nature)does use of laser in addition compared to conventional Rx lead to early function restoration

03 • …. Wants to discuss the Manual therapy for BPV. He heard from many sources about persistent side effects like dizziness, spinal cord damage in future. You know that the risk is low and you have to give a satisfactory statement • Q: in patients with BPV does having MT (compared to no MT ) increases the risk of persistent dizziness & SC damage in future