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6. Example scenarios using the PICO format
6. Example scenarios using the PICO format
A series of example case scenarios for you to consider are now given.
For each example, we suggest you attempt to write out a PICO question, and then expand the text to see an example provided in the PICO format.
You can use the tool PICO.vet to help you build a well-structured and focused clinical question.
Clinical Scenario
Carprofen and local anaesthesia in calves undergoing disbudding
During a visit to one of your small beef herds, the owner, Mary Reader, asks you to disbud three calves that have been born within the last few weeks. The last time Mrs Reader had animals disbudded with hot iron cautery, she was upset by how the animals behaved after the procedure – she says they were “out of sorts” and looked uncomfortable.
Whilst Mrs Reader knows the animals must be disbudded, she asks you whether analgesics as well as the local anaesthetic would be likely to reduce the pain from the disbudding. You assure her you always use local anaesthetic, but you wonder if the addition of carprofen would decrease the level of discomfort experienced by the calves.
In [calves undergoing non-chemical disbudding] does [the administration of carprofen in addition to local anaesthetic] versus [local anaesthetic alone] [decrease the behavioural indicators of discomfort associated with the procedure]?
Clinical Scenario
Carprofen in dairy cattle with toxic mastitis
During a visit to one of your
dairy farms, the owner Steve Jones comments that he has had a number of cows sick with mastitis, which he thinks are caused by E. coli. He finds these cases very difficult to treat.
Steve has recently seen an advert for an anti-inflammatory drug containing carprofen, which claims that it will improve the recovery rate of cows with toxic mastitis. Over the years, you have had a number of conversations with Steve about the relative merits of different treatment options for cases of toxic E. coli mastitis. You wonder if carprofen would make a difference to recovery of cows on Steve’s farm.
In [dairy cattle with E. coli mastitis] does [the administration of carprofen] compared to [no anti-inflammatory treatment] [improve clinical recovery]?
Clinical Scenario
Anchoring versus pocket technique for surgical repair of cherry eye in dogs
You are presented with a 1-year-old Beagle with a unilateral cherry eye. It has been present for two months and is not bothering the dog. The owner wants to know what to do. You ring the two veterinary ophthalmologists in the local area for advice. One routinely performs an anchoring technique, whilst the other has had good results with a mucosal pocket technique. Having only two expert opinions to go by, you decide to look for any available higher-level evidence.
In [dogs undergoing surgery for repair of a prolapsed gland of the third eyelid (cherry eye)], is [a pocket technique] superior to [an anchoring technique] in [preventing recurrence]?
Clinical Scenario
Renal diets in cats with chronic kidney disease
Chloe, a 14-year-old
domestic shorthaired cat, has just been diagnosed with IRIS late stage II kidney disease. She is not proteinuric, and her blood pressure is normal. You have stabilised her azotaemia, and her appetite is now good. What is the benefit of
a kidney prescription diet for this cat?
In [cats with naturally occurring chronic kidney disease] does [a renal prescription diet] compared to [normal diet] increase the [survival time] of affected cats?