PICO & Search Strategy Worksheet: Name: Macayla Greiner

PICO & Search Strategy Worksheet
Name: Macayla Greiner
1. Define your question using the PICO strategy
Elements of a Good Question Your Scenario:

Patient, Population Or Problem: Describe - Female
key patient features.
- Athlete
- ACL tear (partial or complete)
- Young adult (17-24 years old)
Intervention: What main intervention, treatment, - The use of oral contraceptives and its effects on ACL
prognostic factor, exposure, etc. am I considering?
tears.
Comparison (If appropriate): What is the - Compared to individuals that do not use oral
alternative treatment (intervention, prognostic factor,
exposure, no treatment, etc.)? contraceptives (control group).
Outcome: What are you trying to accomplish, - Attempting to find a possible protective mechanism in
improve, or affect? Remember you must be able to
measure an outcome. ACL tears for young females that reduces risk and
incidence of ACL tears (partial or complete).
2. Use the PICO elements to formulate an answerable clinical question.

The Question is: -Does the use of oral contraceptives reduce the risk and
incidence of ACL tears (partial and complete) in young adult
female athletes?
1
3. Plan your Search Strategy

a. How would you categorize this question?
□ Therapy □ Prevention □ Diagnosis □ Etiology □ Prognosis

□ Other_____________
b. i. What type of evidence would best answer this question (Meta-Analysis,
Systematic Review, RCT, Cohort Study, Case Control Study, Case
series or Report, Editorials, Letters, Opinions, Animal Research, in
Vitro/Lab Research, etc.). ii. If you do not find this, what would be your
next choice? iii. What type do you think you will find?
- SR of RCT: This would be the gold standard to answer my specific

preventative question because it would provide me with information
in pool data on several past studies that directly looked at the effects
of oral contraceptive use on ACL tear incidence compared to a control
group that are not taking oral contraceptives. However, due to
extensive ethical issues of instructing individuals to take oral
contraceptives for research purposes,
2
I will likely not be able to find
much of this type of evidence.
-RCT: The next best type of evidence to answer this question would
be a single RCT. This will provide me with a good comparison of
individuals taking oral contraceptives to those that are not and the
difference in incidence of ACL injuries between the two groups.
Additionally, I will be able to look specifically at a population that
coincides with my particular question. Again, however, I do not
anticipate finding this type of evidence due to ethical issues.
-Meta Analysis of cohort: A meta-analysis of cohort studies would
be my next best option because it will provide me with information in
pool data of a population similar to my specific question. This type of
evidence will provide me with information on comparison of
individuals that use oral contraceptives to those that do not and the
ACL injury rates. I also believe this type of evidence will be fairly
readily available in my search and I will be able to find this type
easily, in contrast to the previous two types of evidence.
c. What are your key inclusion criteria (sex, age, species, years . . .)?
Human
Young Adult
Female
Athlete
Last 5 years
d. What are your exclusion criteria (any confounding or irrelevant terms

you want to exclude)?
Elder individuals
Pre-Puberty Individuals
Other injuries other than ACL tears
Any conditions or diseases that affect hormonal levels in females
e. Where will you search (EBM Reviews, PEDro, CINAHL, etc.), which
will be your first choice, and why? If this does not work, where next?
1. PubMed: I will begin my search in PubMed because it is a very

extensive health care database and I expect there to be a considerable
amount of research on ACL injuries. Additionally, in PubMed, I will
be able to refine my search easily using their advanced search in order
to search for my specific question and population.
2. CINAHL: This is a nursing and allied health database with health
care research with multiple journals and articles readily available.
This is not as large of a database as PubMed and may not contain as
many articles that are specific to physical therapy or sports-related
injuries.
4. Select your article

a. Include a clear description of how you refined your search and
ultimately reached a decision on an article. Explain why you made your
choice.
- I began my search for my article on PubMed. Using their advanced
search, I included the terms “oral contraceptive” and “acl tear”. This
gave me a total of 21 articles.
- Next, I refined my search by limiting the articles to the last 5 years,
which decreased the total number of articles to 9.
- I chose to add in the term “athlete” into my advanced search as well,
to see if I could narrow down the articles to those studies that
specifically looked at the population that I am interested in for my
question. This gave me a total of 4 articles.
- From there, I skimmed through the abstracts of the 4 articles to search
for the one that most accurately represented my specific question.
- After scanning each of the 4 articles, I chose my article because of its
large sample size and inclusion of the specific population that I was
looking at for my question. Although
3 it included both young adult
females and middle-aged females, the results that were found
emphasized the effects of oral contraceptives in young adults
specifically. Additionally, after researching the database that was used
for this specific study, I found that it was a valid resource and used in
other studies as well, which solidified the evidence.
b. List the article in correct AMA format using AMA Stat! or the AMA
manual as your guide and using the correct journal title abbreviations.
Defroda SF, Bokshan SL, Worobey S, Ready L, Daniels AH, Owens BD. Oral contraceptives
provide protection against anterior cruciate ligament tears: a national database study of 165,748
female patients. Phys Sportsmed. 2019;1-5. doi:10.1080/00913847.2019.1600334.
PICO & SEARCH STRATEGY ASSESSMENT
Student Name: ____________________________ 4
1. Clinical Question/PICO (15 points) _________________
2. Search Strategy and Explanation of Rationale (20 points) __________________

a. Category of Question
b. Type of Evidence
c. Inclusion and Exclusion Criteria
d. Choice of places to search
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3. Selection of Article (15 points) __________________
a. Description of search results and selection process
b. Article selection
c. Article in correct AMA format
7
Comment Summary
Page 2
1. very good
2. great
Page 4
3. good explanation
Page 5
4. 15
5. 20
6. 15
7. 50

PICO & Search Strategy Worksheet: Name: Macayla Greiner

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PICO & Search Strategy Worksheet: Name: Macayla Greiner

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PICO & Search Strategy Worksheet

Name: Macayla Greiner

1. Define your question using the PICO strategy

Elements of a Good Question Your Scenario:

2. Use the PICO elements to formulate an answerable clinical question.

3. Plan your Search Strategy

□ Therapy □ Prevention □ Diagnosis □ Etiology □ Prognosis

- SR of RCT: This would be the gold standard to answer my specific

d. What are your exclusion criteria (any confounding or irrelevant terms

Other injuries other than ACL tears

Any conditions or diseases that affect hormonal levels in females

1. PubMed: I will begin my search in PubMed because it is a very

4. Select your article

Student Name: ____________________________ 4

1. Clinical Question/PICO (15 points) _________________

2. Search Strategy and Explanation of Rationale (20 points) __________________

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