DNP 801 Topic 2 Discussion Question Two
DNP 801 Topic 2 Discussion Question Two
Review the “PICOT Selection Guidelines” resource.
Using the PICOT format, formulate one evidence-based practice (EBP) question in correct format. Follow the selection guidelines in order to choose an appropriate topic idea that can be supported with empirical research.
In 150-200 words, justify why this topic fits the PICOT guidelines and is worthy of additional investigation.
Submit your PICOT question and supporting articles to the discussion forum for feedback.
Prepare this discussion question according to the guidelines found in the APA style guide, located in the Student Success Center. An abstract is not required.
The PICOT format is a helpful approach for summarizing research questions that explore the effect of therapy:5
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(P) – Population refers to the sample of subjects you wish to recruit for your study. There may be a fine balance between defining a sample that is most likely to respond to your intervention (e.g. no co-morbidity) and one that can be generalized to patients that are likely to be seen in actual practice.
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(I) – Intervention refers to the treatment that will be provided to subjects enrolled in your study.
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(C) – Comparison identifies what you plan on using as a reference group to compare with your treatment intervention. Many study designs refer to this as the control group. If an existing treatment is considered the ‘gold standard’, then this should be the comparison group.
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(O) – Outcome represents what result you plan on measuring to examine the effectiveness of your intervention. Familiar and validated outcome measurement tools relevant to common chiropractic patient populations may include the Neck Disability Index6 or Roland-Morris Questionnaire.7 There are, typically, a multitude of outcome tools available for different clinical populations, each having strengths and weaknesses.
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(T) – Time describes the duration for your data collection.
RCT Design Example Using PICOT
Dosage effects of spinal manipulative therapy for chronic neck pain
Neck pain is second in frequency only to low back pain among musculoskeletal complaints reported in the general population and among those presenting to manual therapy providers.8,9 Chronic neck pain (i.e. neck pain lasting longer than 90 days) is a common reason for presenting to a chiropractor’s office, and such patients often receive spinal manipulation or mobilization.10 Recent systematic reviews of RCTs and prior observational studies have shown increases in cervical range of motion,11,12 and decreases in self-rated neck pain13,14 following cervical spine manipulation. In 2010, the Cochrane systematic review concluded, “Optimal technique and dose need to be determined.”14
Despite evidence of benefit, there is a limited understanding of the optimal dose for neck manipulation; as such, frequency and duration of this treatment varies greatly between clinicians. Although patient characteristics and clinicians’ beliefs likely account for some of this variation, it seems likely that many cases of mechanical neck pain will require a minimal number of spinal manipulative therapy (SMT) treatments to derive benefit and that no further benefit will result after a certain upper threshold is reached. To properly examine the dose effects of manipulation for neck pain, it is necessary to consider three treatment factors:
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frequency
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intensity
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total number of manipulations