Respiratory Therapy

The key to finding appropriate evidence is to ask a searchable, answerable question.  The PICO framework is often used as a guide for asking clinical questions.

Have you noticed resources that refer to PICOT instead of PICO?  Some EBP experts add T to the standard PICO framework.  The T usually stands for time and can be helpful in making sure you're thinking of the appropriate time frame for your intervention and/or outcomes.

Video created by Show Me The Evidence.

Example 1

You are working with a patient who has COPD and wonder if you should consider adding a short-acting bronchodilator to the long-acting bronchodilator maintenance therapy.

P = COPD

I = long-acting bronchodilator + short-acting bronchodilator (bifunctional bronchodilator)

C = long-acting bronchodilator alone

O = improved forced expiratory volume  (FEV1)

"In COPD patients, how does adding a short-acting bronchodilator to a long-acting bronchodilator impact FEV1?"

Example 2

You have a patient with obstructive sleep apnea who does not like their CPAP, and you wonder how using an EPAP (expiratory positive airway pressure) machine would compare.

P = obstructive sleep apnea (OSA)

I = expiratory positive airway pressure (EPAP)

C = continuous positive airway pressure (CPAP)

O = functional residual capacity (FRC)

"In patients with obstructive sleep apnea, how does using a CPAP machine compare with an EPAP machine in affecting functional residual capacity?"