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Case 1 The mother of a 5-year-old boy with a history of asthma has brought him to the emergency room with an acute exacerbation of his condition. She wants to know if this episode could be treated with a single injection of dexamethasone rather than a 5-day course of oral prednisolone, since she has had problems in the past getting him to take his medicine.
Let’s build the PICO P: ?? Children with acute asthma exacerbation I: ?? Single-dose injectabledexamethasone C: ?? Oral prednisolone x 5 days O: ?? Resolution of asthma symptoms
Clinical Question In a child with an acute asthma attack, does a single-dose injection of dexamethasone work as well as 5-day oral prednisolone in resolving asthmatic symptoms?
Case 2 A 25-year-old man with newly-diagnosed schizophrenia comes to you, his primary care physician, after gaining 18 pounds in the first 6 months since starting olanzopine. Concerned because his mother has diabetes, he asks you to help him lose weight safely.
Case 2, continued You make your usual recommendations that he increase physical activity and decrease total daily caloric intake, but you know the chances of success are not high. You recall hearing about a study that said metformin may help in this situation, and decide to review the evidence.
Let’s build the PICO P: ?? Adult males with schizophrenia and weight gain on olanzapine therapy I: ?? Metformin C: ?? Lifestyle changes alone O: ?? Weight loss
Clinical Question In adult male schizophrenics with weight gain on olanzapine therapy, does the addition of metformin to standard lifestyle changes alone result in increased weight loss?
Your Turn • Work with a partner • Pick one of your previous phase cases • Write a PICO using the case features • Write a clinical question from the PICO • Submit online by 9:00 AM tomorrow to: http://med.mercer.edu/libraries/pico-macon.htm (Macon) http://med.mercer.edu/libraries/pico-savannah.htm (Savannah) • Ask for help if you need it!
Your PICOs will be reviewed by MUSM librarians and will be used to complete searching exercises during next week’s class.