Health care reform poses major challenges for psychiatric mental health care. Foremost among the challenges is a mandate for reimbursement based on performance-based outcomes. Clinicians can increase the efficiency of evidence-based practice searches by using the correct form of PICOT (population, intervention, comparator, outcome, time frame) question to focus the search, based on (a) diagnosis, (b) treatment, (c) prognosis, (d) etiology, (e) prevention, and (f) meaning. The correct form of a PICOT question focuses the literature search by requiring a minimum of sorting to find relevant studies. Quickly and effectively locating the critical evidence will help meet the performance standard mandates required by new health care reform legislation.
Aaron, H.J., & Reischauer, R.D. (2010). The war isn’t over . New England Journal of Medicine. doi:10.1056/NEJMp1003394
2.
Bauer, R.M. ( 2007). Evidence-based practice in psychology: Implication for research and research training. Journal of Clinical Psychology , 63, 685-694.
Bliss-Holtz, J. ( 2007). Evidence-based practice: A primer for action. Issues in Comprehensive Pediatric Nursing, 30, 165-182.
5.
Bobes, J., Arango, C., Aranda, P., Carmena, R., Garcia-Garcia, M., & Rejas, J. ( 2007). Cardiovascular and metabolic risk in outpatients with schizophrenia treated with antipsychotics: Results of the CLAMORS study. Schizophrenia Research, 90, 162-173.
6.
Clancy, C.P., Graybeal, A., Tompson, W.P., Badgett, K.S., Feldman, M.E., Calhoun, P.S., . . . Beckham, J.C. ( 2006). Lifetime trauma exposure in veterans with military-related posttraumatic stress disorder: Association with current symptomatology. Journal of Clinical Psychiatry, 67, 1346-1353.
7.
Cuijpers, P., Van Straten, A., & Smit, F. ( 2005). Preventing the incidence of new cases of mental disorders: A meta-analytic review. Journal of Nervous and Mental Disease , 193, 119-125.
8.
Dedert, E.A., Green, K.T., Calhoun, P.S., Yoash-Gantz, R., Taber, K.H., Mumford, M.M., . . . Beckham, J.C. ( 2009). Association of trauma exposure with psychiatric morbidity in military veterans who have served since September 11, 2001 . Journal of Psychiatric Research, 43, 830-836.
9.
De Graeve, D., Smet, A., Mehnert, A., Caleo, S., Miadi-Fargier, H., Mosqueda, G.J., . . . Pueskens, J. ( 2005). Long-acting risperidone compared with oral olanzapine and haloperidol depot in schizophrenia: A Belgian cost-effectiveness analysis . PharmacoEconomics, 23(Suppl. 1), 35-47.
10.
Dow, M.G., Kenardy, J.A., Johnston, D.W., Newman, M.G., Taylor, C.B., & Thomson, A. ( 2007). Prognostic indices with brief and standard CBT for panic disorder: II. Moderators of outcome. Psychological Medicine , 37, 1503-1509.
11.
Edwards, N.C., Locklear, J.C., Rupnow, M.F., & Diamond, R.J. ( 2005). Cost effectiveness of long-acting risperidone injection versus alternative antipsychotic agents in patients with schizophrenia in the USA. PharmacoEconomics, 23(Suppl. 1), 75-89.
12.
Fava, G.A., Ruini, C., Rafanelli, C., Finos, L., Conti, S., & Grandi, S. ( 2004). Six-year outcome of cognitive behavior therapy for prevention of recurrent depression. American Journal of Psychiatry, 161, 1872-1876.
13.
Fiedorowicz, J.G., Palagummi, N.M., Forman-Hoffman, V.L., Miller, D.D., & Haynes, W.G. ( 2008). Elevated prevalence of obesity, metabolic syndrome, and cardiovascular risk factors in bipolar disorder. Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists, 20, 131-137.
14.
Fineout-Overholt, E., Hofstetter, S., Shell, L., & Johnston, L. ( 2005). Teaching EBP: Getting to the gold: How to search for the best evidence. Worldviews on Evidence-Based Nursing, 2, 207-211.
15.
Fineout-Overholt E., Levin RF, & Melnyk BM ( 2004). Strategies for advancing evidence-based practice in clinical settings. Journal of the New York State Nurses Association , 1, 28-31.
16.
Fineout-Overholt, E., & Johnston, L. ( 2005). Teaching EBP: Asking searchable, answerable clinical questions. Worldviews on Evidence-Based Nursing, 2, 157-160.
17.
Franz, L., Carter, T., Leiner, A.S., Bergner, E., Thompson, N.J., & Compton, M.T. ( 2010). Stigma and treatment delay in first-episode psychosis: A grounded theory study. Early Intervention in Psychiatry , 4, 47-56.
18.
Furlanetto, L.M., Mendlowicz, M.V., & Romildo Bueno, J. (2005). The validity of the Beck Depression Inventory-Short Form as a screening and diagnostic instrument for moderate and severe depression in medical inpatients. Journal of Affective Disorders, 86, 87-91.
19.
Galderisi, S., Mucci, A., Volpe, U., & Boutros, N. ( 2009). Evidence-based medicine and electrophysiology in schizophrenia . Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS), 40, 62-77.
20.
Gerson, R., Davidson, L., Booty, A., McGlashan, T., Malespina, D., Pincus, H.A., & Corcoran, C. ( 2009). Families’ experience with seeking treatment for recent-onset psychosis. Psychiatric Services, 60, 812-816.
21.
Goikolea, J.M., Colom, F., Martinez-Aran, A., Sanchez-Moreno, J., Giordano, A., Bulbena, A., & Vieta, E. ( 2007). Clinical and prognostic implications of seasonal pattern in bipolar disorder: A 10-year follow-up of 302 patients. Psychological Medicine, 37, 1595-1599.
22.
Gray, G.E. ( 2010). Asking answerable questions. In C. B. Taylor (Ed.), How to practice evidence-based psychiatry: Basic principles and case studies (pp. 17-19). Arlington, VA : American Psychiatric Publishing.
23.
Health care reform: ACOs and developments in coordinated care delivery, shared savings and bundled payments. (2010, April, 14). McDermott Newsletters. Retrieved from http:// www.mwe.com/index.cfm/fuseaction/publications.nldetail/object_id/6699b22c-127a-4cf0-a80b-bab7a75767de.cfm
24.
Howard, W.T., Evans, K.K., Quintero-Howard, C.V., Bowers, W.A., & Andersen, A.E. (1999). Predictors of success or failure of transition to day hospital treatment for inpatients with anorexia nervosa. American Journal of Psychiatry, 156, 1697-1702.
25.
Huang, X., Lin, J., & Demner-Fushman, D. (2006). Evaluation of PICO as a knowledge representation for clinical questions. AMIA Annual Symposium Proceedings, 2006, 359-363.
26.
Johnston, L., & Fineout-Overholt, E. (2005). Teaching EBP: "getting from zero to one." moving from recognizing and admitting uncertainties to asking searchable, answerable questions. Worldviews on Evidence-Based Nursing, 2, 98-102.
27.
Kornor, H., Winje, D., Ekeberg, O., Weisaeth, L., Kirkehei, I., Johansen, K., & Steiro, A. ( 2008). Early trauma-focused cognitive-behavioural therapy to prevent chronic posttraumatic stress disorder and related symptoms: A systematic review and meta-analysis. BMC Psychiatry, 8, 81.
28.
Lapp, K.G., Bosworth, H.B., Strauss, J.L., Stechuchak, K.M., Horner, R.D., Calhoun, P.S., . . . Butterfield, M.I. (2005). Lifetime sexual and physical victimization among male veterans with combat-related post-traumatic stress disorder. Military Medicine, 170, 787-790.
29.
Lindner, L.M., Marasciulo, A.C., Farias, M.R., & Grohs, G.E. ( 2009). Economic evaluation of antipsychotic drugs for schizophrenia treatment within the Brazilian healthcare system. Revista De Saude Publica, 43(Suppl. 1), 62-69.
30.
Llorca, P.M., Miadi-Fargier, H., Lancon, C., Jasso Mosqueda, G., Casadebaig, F., Philippe, A., . . . Durand-Zaleski, I. (2005). Analyse cout-efficacite des strategies de prise en charge des patients schizophrenes: place d’un antipsychotique atypique sous forme injectable a liberation prolongee [Cost-effectiveness analysis of schizophrenic patient care settings: Impact of an atypical antipsychotic under long-acting injection formulation]. L’Encephale , 31, 235-246.
31.
Lowe, B., Spitzer, R.L., Grafe, K., Kroenke, K., Quenter, A., Zipfel, S., . . . Herzog, W. ( 2004). Comparative validity of three screening questionnaires for DSM-IV depressive disorders and physicians’ diagnoses. Journal of Affective Disorders, 78, 131-140.
32.
Lucas, S., Redoblado-Hodge, M.A., Shores, A., Brennan, J., & Harris, A. ( 2008). Predictors of outcome three years after diagnosis of first episode psychosis. Psychiatry Research, 161, 11-18.
33.
Lyons, C., Hopley, P., & Horrocks, J. ( 2009). A decade of stigma and discrimination in mental health: Plus ça change plus c’est la même chose (the more things change, the more they stay the same). Journal of Psychiatric and Mental Health Nursing, 16, 501-507.
34.
Medina, J. ( 2010, April 7). Epigenetics of stress. Psychiatric Times. Retrieved from http://www.psychiatrictimes.com/traumatic-stress-disorders/content/article/10168/1550433
35.
Melnyk, B.M., & Fincout-Overholt, E. (2002). Key steps in implementing evidence-based practice: Asking compelling, searchable questions and searching for the best evidence. Pediatric Nursing, 22, 262-263.
36.
Morse, J.M. ( 2006). The politics of evidence. Qualitative Health Research, 16, 395-404.
37.
Murphy, C.M., Morrel, T.M., Elliott, J.D., & Neavins, T.M. ( 2003). A prognostic indicator scale for the treatment of partner abuse perpetrators. Journal of Interpersonal Violence, 18, 1087-1105.
38.
Nuevo, R., Lehtinen, V., Reyna-Liberato, P.M., & Ayuso-Mateos, J.L. (2009). Usefulness of the beck depression inventory as a screening method for depression among the general population of Finland. Scandinavian Journal of Public Health , 37, 28-34.
39.
Obradovic, M., Mrhar, A., & Kos, M. ( 2007). Cost-effectiveness of antipsychotics for outpatients with chronic schizophrenia. International Journal of Clinical Practice, 61), 1979-1988.
40.
Orcutt, H.K., King, L.A., & King, D.W. ( 2003). Male-perpetrated violence among Vietnam veteran couples: Relationships with veteran’s early life characteristics, trauma history, and PTSD symptomatology. Journal of Traumatic Stress, 16, 381-390.
41.
Patel, M.X., Young, C., Samele, C., Taylor, D.M., & David, A.S. ( 2004). Prognostic indicators for early discontinuation of risperidone long-acting injection. International Clinical Psychopharmacology , 19, 233-239.
42.
Pavics, L., Szekeres, G., Ambrus, E., Keri, S., Kovacs, Z., Argyelan, M., . . . Janka, Z. ( 2004). The prognostic value of dopamine receptor occupancy by [123I] IBZM-SPECT in schizophrenic patients treated with quetiapine. Nuclear Medicine Review. Central & Eastern Europe: Journal of Bulgarian, Czech, Macedonian, Polish, Romanian, Russian, Slovak, Yugoslav Societies of Nuclear Medicine and Ukrainian Society of Radiology, 7, 129-133.
43.
Rafrafi, R., Zaghdoudi, L., Mahbouli, M., Bouzid, R., Lab-bane, R., & El Hechmi, Z. ( 2009). Pronostic social des schizophrenies en Tunisie: Etude transversale a propos de 60 cas [Social outcome of schizophrenics in Tunisia: A transversal study of 60 patients]. L’Encephale, 35, 234-240.
44.
Rice, M.J. ( 2008a). Metasynthesis: Qualitative data in evidence based psychiatric care. Journal of the American Psychiatric Nurses Association , 14, 382-385.
45.
Rice, M.J. ( 2008b). Psychiatric mental health evidence-based practice. Journal of the American Psychiatric Nurses Association, 14, 107-111.
46.
Rice, M.J. ( 2008c). Qualitative meta-synthesis. Journal of the American Psychiatric Nurses Association, 14, 382-385.
47.
Rice, M.J. ( 2009). Effect size in psychiatric evidence-based practice care . Journal of the American Psychiatric Nurses Association, 15, 138-142.
48.
The Robert Wood Johnson Foundation. (2010). National quality forum develops first national performance standards for nursing care-Grant results. Retrieved from http://www.rwjf.org/reports/grr/047479.htm#Recommendations
49.
Sandelowski, M. ( 2004). Using qualitative research. Qualitative Health Research, 14, 1366-1386.
50.
Sandelowski, M., Barroso, J., & Voils, C.I. ( 2007). Using qualitative metasummary to synthesize qualitative and quantitative descriptive findings. Research in Nursing & Health, 30, 99-111.
51.
Sandelowski, M., Trimble, F., Woodard, E.K., & Barroso, J. ( 2006). From synthesis to script: Transforming qualitative research findings for use in practice. Qualitative Health Research , 16, 1350-1370.
52.
Sicras-Mainar, A., Blanca-Tamayo, M., Rejas-Gutierrez, J., & Navarro-Artieda, R. (2008). Metabolic syndrome in outpatients receiving antipsychotic therapy in routine clinical practice: A cross-sectional assessment of a primary health care database. European Psychiatry: Journal of the Association of European Psychiatrists , 23, 100-108.
53.
Venhaus, C.K. ( 2010). Social construction of mental illness among rural and frontier persons with severe and persistent mental illness. ProQuest Information & Learning. Dissertation Abstracts International: Section B: The Sciences and Engineering, 70(8).
54.
Viinamaki, H., Tanskanen, A., Honkalampi, K., Koivumaa-Honkanen, H., Haatainen, K., Kaustio, O., & Hintikka, J. ( 2004). Is the Beck Depression Inventory suitable for screening major depression in different phases of the disease? Nordic Journal of Psychiatry, 58, 49-53.
55.
Virgilio, R.F., Chiapa, A.L., & Palmarozzi, E.A. (2007). Evidence-based medicine, part 1. An introduction to creating an answerable question and searching the evidence. Journal of the American Osteopathic Association , 107, 295-297.
