Evidence Based Library and Information Practice

Introduction Questions are the driving force behind evidence based practice (EBP) (Eldredge, 2000). If there were no questions, EBP would be unnecessary. Evidence based practice questions focus on practical real-world problems and issues. The more urgent the question, the greater the need to place it in an EBP context. One of the most challenging aspects of EBP is to actually identify the answerable question. This ability to identify the question is fundamental to then locating relevant information to answer the question. An unstructured collection of keywords can retrieve irrelevant literature, which wastes time and effort eliminating inappropriate information. Successfully retrieving relevant information begins with a clearly defined, well-structured question. A standardized format or framework for asking questions  Evidence Based Library and Information Practice

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helps focus on the key elements. Question generation also enables a period of reflection. Is this the information I am really looking for? Why I am looking for this information? Is there another option to pursue first? This paper introduces the first published framework, PICO (Richardson, Wilson, Nishikawa and Hayward, 1995) and some of its later variations including ECLIPSE (Wildridge and Bell, 2002) and SPICE (Booth, 2004). Sample library and information science (LIS) questions are provided to illustrate the use of these frameworks to answer questions in disciplines other than medicine. Booth (2006) published a broad overview of developing answerable research questions which also considered whether variations to the original PICO framework were justifiable and worthwhile. This paper will expand on that work Evidence Based Library and Information Practice

Question Frameworks in Practice PICO The concept of PICO was introduced in 1995 by Richardson et al. to break down clinical questions into searchable keywords. This mnemonic helps address these questions: P – Patient or Problem: Who is the patient? What are the most important characteristics of the patient? What is the primary problem, disease, or co-existing condition? I – Intervention: What is the main intervention being considered? C – Comparison: What is the main comparison intervention? O – Outcome: What are the anticipated measures, improvements, or affects? Medical Scenario and Question: An overweight woman in her forties has never travelled by airplane before. She is planning an anniversary holiday with her husband including several long flights. She is concerned about the risk of deep vein thrombosis. She would like to know if compression stockings are effective in preventing this condition or whether a few exercises during the flight would be enough. P – Patient / Problem: Female, middle-aged, overweight I – Intervention: Compression stockings C – Comparison: In-flight exercises O – Outcome: Prevent deep vein thrombosis The PICO framework and its variations were developed to answer health-related questions. With a slight modification, this framework can structure questions related to LIS. The P in PICO refers to patient, but substituting population for patient provides a question format for all areas of librarianship. The population may be children, teens, seniors, those from a specific ethnic group, those with a common goal (e.g., job-seekers), or those with a common interest (such as a gardening club). The intervention is the new concept being considered, such as longer opening hours, a reading club, after-school activity, resources in a particular language, or the introduction of wi-fi.

LIS Scenario and Question: Art history master’s students submit theses with more bibliography errors than those from students of other faculties. The Dean of art history raised this issue with the head librarian. The head librarian suggested that database training could help. P – Population: Art History master’s students I – Intervention: database searching training C – Comparison: students with no training or students from other Faculties O – Outcome: Improved bibliographic quality Table 1 illustrates the different components introduced in several PICO framework variations. Fineout-Overholt and Johnson (2005) considered the questioning behavior of nurses. They suggested a five-component scheme for evidence based practice questions using the acronym PICOT, with T representing timeframe. This refers to one or more time-related variables such as the length of time the treatment should be prescribed or the point at which the outcome is measured. A PICOT question in the LIS field is: In a specialist library, does posting the monthly library bulletin on the Website instead of only having printed newsletters available result in increased usage of the library and the new resources mentioned in the bulletin? In this question, the timeframe refers to a month. Petticrew and Roberts (2005) suggested PICOC as an alternative ending to PICOT, with C representing context. For example, what is the context for intervention delivery? In LIS, context could be a public library, academic library, or health library. A variation similar to PICOT is PICOTT. In this instance, neither T relates to timeframe. The Ts refer to the type of question and the best type of study design to answer that particular question (Schardt, Adams, Owens, Keitz, and Fontelo, 2007). An example LIS question is: In a specialist library, does instant messaging or e-mail messaging result in the greatest customer satisfaction with a virtual reference service? This type of question is user analysis, and a relevant type of study design is Evidence Based Library and Information Practice

a questionnaire. The PICOTT framework may be too restrictive when searching. If you are searching for effective Websites then transaction log analysis would be a reasonable type of study design. By limiting to that study type you would miss user observation studies, focus groups, and controlled experiments. These frameworks should focus the search strategy, while not excluding potentially useful and relevant information. Specifically developed for building and adapting oncology guidelines is PIPOH (ADAPTE Collaboration, 2009). The second P refers to professionals (to whom the guideline will be targeted) and H stands for health care

setting and context (in which the adapted guideline will be used). An example of this in the LIS setting would be: What is appropriate training for fieldwork students working on the library’s issue or circulation desk? P – Population: Library users I – Intervention: Training P – Professionals: Fieldwork students O – Outcome: S – Setting: Issue or circulation desk Dawes et al. (2007) developed PECODR and undertook a pilot study to determine whether this structure existed in medical journal abstracts. E refers to exposure, replacing Evidence Based Library and Information Practice