When constructing your PICO question, a few important points to bear in mind: Your patient is a member of a population as well as a person with (or at risk for) a health problem . Factors to consider include age, sex, comorbid conditions, past medical history, socioeconomic status or other demographic variables, as these factors may impact your ...When you formulate a PICO question, you are creating a formula that does several things: Focus the question by identifying the components or concepts in the question. Defines the concepts that will be used when performing a complex literature search. Used to ascertain which articles in a search retrieval best address the question.Apr 29, 2011 · I need a PICO question over either pregnancy, pregnancy complications, postpartum, newborn, premature newborn, anything along those lines. I know how to make a PICO question so I am not asking that. I am just having trouble with this area and exploring things I could do one over and find articles with. Thanks! Apr 29, 2011 · I need a PICO question over either pregnancy, pregnancy complications, postpartum, newborn, premature newborn, anything along those lines. I know how to make a PICO question so I am not asking that. I am just having trouble with this area and exploring things I could do one over and find articles with. Thanks! PICOT is a mnemonic resulting from the elements of clinical research. The PICOT process starts with a particular case, and the question is couched to develop an answer. A PICOT question helps you get the answer to your clinical question. It serves as a framework, prompting you to consider various aspects of the topic under investigation.You need to assess what reasonable clinical study population your patient could be part of. For example, if your patient is a 73 year old woman, "73 year old women" or "women in their 70s" is too specific because it is highly unlikely that clinical researchers would design a study that would exclusively enroll women in their 70s.The list of PICOT question examples will be incomplete if we didnâ&#x20AC;&#x2122;t mention a question about severe malnutrition. 23. Can antibiotics prevent death and sequelae in kids ...A PICO question, sometimes written as a PICOT question, comprises several elements: P – Population, patient, problem. I – Intervention. C – Comparison or control. O – Outcome or objective. T – Time frame (optional component). 📚 PICO Question Types. There are 5 key types of PICO questions. Look at the table below to learn more about ...These questions bring together multiple concepts related to a specific clinical situation or research topic. They are typically divided into two categories: Qualitative Questions aim to discover meaning or gain an understanding of a phenomena. They ask about an individual's or population's experience of certain situations or circumstances.Aug 16, 2023 · 2. Foreground questions are specific knowledge questions . that affect clinical decisions and ; include a broad range of biological, psychological, and sociological issues. Foreground questions are best suited to the PICO model as it captures the essential elements of your information need to help translate that question into a search query. To ... The PICOT question format is a consistent “formula” for developing answerable, researchable questions. When you write a good one, it makes the rest of the process of finding and evaluating evidence much more straightforward. P: Population/patient – age, gender, ethnicity, individuals with a certain disorder. I: Intervention/indicator ...Mar 23, 2023 · Developing a Targeted Research Question. Examine your topic to identify the major concepts you need to conduct the best searches. Some useful ways to do this include: Background planning: think of the 5 W's and H for your topic: Who - are the stakeholders, population of interest, involved parties. What - are the issues, problems, needs. When constructing your PICO question, a few important points to bear in mind: Your patient is a member of a population as well as a person with (or at risk for) a health problem . Factors to consider include age, sex, comorbid conditions, past medical history, socioeconomic status or other demographic variables, as these factors may impact your ...“The question needs to identify the patient or population we intend to study, the intervention or treatment we plan to use, the comparison of one intervention to another (if applicable) and the outcome we anticipate,” Kathy A. Jensen, MHA, RN, wrote in EBSCO Health’s whitepaper, “7 Steps To The Perfect Pico Search.” “Once a well ... Aug 24, 2023 · PICO (T) Evidence-based practice uses the PICO (T) model for formulating a searchable question. PICO (T) is a mnemonic used to describe the four elements of a good clinical foreground question: P = Population/Problem. How would I describe the problem or a group of patients similar to mine? I = Intervention. PICOT Question. The emotional wellbeing of mothers is linked to the positive upbringing of children in the first several months of their lives. However, the physical, hormonal, and psychological changes that occur after labor can significantly undermine women’s well-being, with adverse symptoms preventing them from having a positive outlook on lives.Clarifying the key elements of the question is a critical first step toward providing an answer to inform a decision, or for a researcher to frame the research to be done. The PICO (Population, Intervention, Comparator, and Outcomes) model captures the key elements and is a good strategy to provide answerable questions. [1] The framework is actually divided into four major elements. A good clinical question will address most, if not all, aspects of the PICO nursing questions. The following are the parameters defined by PICO (T) when it comes to designing of clinical questions: P: Patient, Problem, Population. I: Intervention. Aug 29, 2023 · Foreground questions look for answers to specific patients, problems, types of interventions, and clinical outcomes, and the PICO framework will work well with these questions. Use PICO to write a clear, researchable clinical question. The four elements of PICO break a research topic into searchable keywords and make locating evidence-based ... Finally, you will click on a button and the PICOT Research Question Generator will present the following: Your PICOT question. Your null and alternative hypotheses. Your independent variable. Your dependent variable. The statistical test used to answer your PICOT question. It should take you less than five minutes to complete the web form below.Apr 20, 2021 · Introduction. Stroke is a medical condition that is caused by the interruption or reduction of blood supply to the brain. This deprives the affected part of brain nutrients and oxygen supply. The biochemical processes are hence stopped, interrupted, or impaired; the brain cells can even die. Further, the condition can also be caused by bursting ... The PICO question in this paper seeked to answer the question: in adult patients without celiac disease or gluten sensitivities, is GF food correlated with higher type 2 diabetes or CVD risk? The question was underpinned by a research study showing an inverse relationship between gluten consumption and type 2 diabetes rates. Have two essential components: Example: What causes migraines? or How often should women over the age of 40 have a mammogram? A question root (who, what, when, etc.) with a verb; A disorder, test, treatment, or other aspect of healthcare; The background question is usually asked because of the need for basic information.Therapy nursing PICOT questions examples include: 12. Use of negative pressure wound therapy on a diabetic patient with stage iii pressure ulcers compared with standard moist wound therapy. 13. Comparing the risks of developing breast cancer among women who use oral contraceptives with those who use IUDs. 14.Appendix H. PICO tables. PICO tables were generated for each question defining the target population, interventions and comparators (where appropriate) and outcomes. These are presented with a summary of the searching activity for each question. Go to: Introduction. Stroke is a medical condition that is caused by the interruption or reduction of blood supply to the brain. This deprives the affected part of brain nutrients and oxygen supply. The biochemical processes are hence stopped, interrupted, or impaired; the brain cells can even die. Further, the condition can also be caused by bursting ...Different types of clinical questions are suited to different syntaxes and phrasings, but all will clearly define the PICO elements. The definitions and frames below may be helpful for organizing your question: Intervention/Therapy. Questions addressing how a clinical issue, illness, or disability is treated.PICO Question: Methods Evidence •Kennard, et al (2006) found a significantly higher remission rate in the SSRI + CBT group (37%) relative to the other treatment groups (SSRI 23%; CBT 16%; placebo, 17%). •Suggests combination therapy (SSRI + CBT) is superior to monotherapy, regardless of whether it is SSRI alone or CBT alone.of the PICO components The PICO question is a convenient and conventional format to use when composing good clinical questions to direct an evidence-based search of research literature. PICO stands for Patient, Intervention, Comparison and Outcome; thus, there are four components of a good clinical question based on the PICO format.Aug 29, 2023 · Foreground questions look for answers to specific patients, problems, types of interventions, and clinical outcomes, and the PICO framework will work well with these questions. Use PICO to write a clear, researchable clinical question. The four elements of PICO break a research topic into searchable keywords and make locating evidence-based ... Aug 24, 2023 · PICO (T) Evidence-based practice uses the PICO (T) model for formulating a searchable question. PICO (T) is a mnemonic used to describe the four elements of a good clinical foreground question: P = Population/Problem. How would I describe the problem or a group of patients similar to mine? I = Intervention. The word PICOT is a mnemonic derived from the elements of a clinical research question – patient, intervention, comparison, outcome and (sometimes) time. The PICOT process begins with a case scenario, and the question is phrased to elicit an answer. “The question needs to identify the patient or population we intend to study, the ...Formulate a PICO Question . Answerable PICO Question: In middle-aged adult females with hypertension, are beta blockers more effective than ACE inhibiters in controlling blood pressure? Image: "Dagstuhl 2008-02-01 - 37" by Nic's events is licensed under CC BY-SA 2.0The PICO question in this paper seeked to answer the question: in adult patients without celiac disease or gluten sensitivities, is GF food correlated with higher type 2 diabetes or CVD risk? The question was underpinned by a research study showing an inverse relationship between gluten consumption and type 2 diabetes rates. These questions are often looking at specific patients or populations, which is why the PICO(T) framework is used. They are often very specific or complex in comparison to background questions (i.e. questions that are routed more in general knowledge or answering an open ended question about an illness, disease, condition, process, or thing).Aug 16, 2023 · 2. Foreground questions are specific knowledge questions . that affect clinical decisions and ; include a broad range of biological, psychological, and sociological issues. Foreground questions are best suited to the PICO model as it captures the essential elements of your information need to help translate that question into a search query. To ... PICO. PICO is a mnemonic used to help you clarify your clinical question. It acts as a framework, asking you to think specifically about different aspects of what you want to investigate. As you build your PICO, you should make sure that you are clear and specific about what you are looking for. This helps you target the right evidence to use ...Components of Pico. P- young adults. I- alcohol consumption. C- no alcohol consumption. O- depression. Exposure: The exposure in this case is alcohol. It is injurious to health and it makes aggressive behavior of people therefore, increasing the level of anxiety. Excessive alcohol intake can interfere with the normal process of development and ...PICOT: This evidence-based project answered the following question: In rehabilitation patients, what is the effect of a nurse-driven protocol (NDP) CAUTI bundle on the number of indwelling urinary catheter-related infections, compared to the current practice, over a 12-week time period? EvidenceYou need to assess what reasonable clinical study population your patient could be part of. For example, if your patient is a 73 year old woman, "73 year old women" or "women in their 70s" is too specific because it is highly unlikely that clinical researchers would design a study that would exclusively enroll women in their 70s.These questions bring together multiple concepts related to a specific clinical situation or research topic. They are typically divided into two categories: Qualitative Questions aim to discover meaning or gain an understanding of a phenomena. They ask about an individual's or population's experience of certain situations or circumstances.PICO: P = population; I = intervention; C = comparator; O = outcome(s)[ref]For further information on the findings of the reviews based on the PICOs presented in this annex, refer to the EtD frameworks in Supplementary material 2.[/ref] Pre-abortion Rhisoimmunization PICO 1: No anti-D administration in unsensitized Rh-negative individuals seeking abortion (see Recommendation 8 [NEW])Sep 6, 2023 · It is important to note that there are different types or categories of PICOT questions. The category of your question can at times dictate the types of evidence that you are searching for. Determine in which category your question would best fit. Use the template to help you word it succinctly and correctly. PICO 4: Vacuum aspiration for all indications at gestational ages < 14 weeks (see Recommendation 24) PICO question: For a pregnant person seeking induced abortion or treatment for incomplete abortion or miscarriage (i.e. all indications for vacuum aspiration), is provision of vacuum aspiration by a traditional and complementary medicine ...This section includes the evidence summaries for each key question. It incorporates a summary of the included review for PICO question 1 and the results of the primary reviews (PICO questions 2–6), other relevant evidence (specifically, related guidelines and systematic reviews) and a summary of the evidence-to-decision framework.The framework is actually divided into four major elements. A good clinical question will address most, if not all, aspects of the PICO nursing questions. The following are the parameters defined by PICO (T) when it comes to designing of clinical questions: P: Patient, Problem, Population. I: Intervention.PICOT QUESTION PAPER: INFERTILITY Significance to Nursing In nursing, fertility is a process that begins from the second a woman states she is attempting to become pregnant but is having difficulty. Nurses are also educators, so a main component to treating a woman who has fertility issues is to make them aware of their options and issues.Examples of Picot Questions. Below are good picot questions examples that can guide you to come up with picot questions. In African American female adolescents with hepatitis B (P), how does acetaminophen (I) compared to ibuprofen (C) affect liver function (O)? (Time is optional). For women who use birth control methods (P), how do birth ...A strength of a qualitative PICO question is that it can investigate what patient satisfaction looks like, for example, instead of only reporting that 25% of patients who took a survey reported that they are satisfied. When working with qualitative questions, an alternative to using PICO in searching for sources is the SPIDER search tool.PICO(T): Definitions and Examples. PICO(T) Model & Question Types; Example 1 - Therapy; Example 2 - Diagnosis/Diagnostic Test; Example 3 - Etiology; Example 4 - Prognosis; Study Designs; Finding Evidence & Information; Critical Appraisal; EBP vs Research vs QI; Journal ClubAug 29, 2023 · Concepts from the PICO(T) question are used to construct a comprehensive database search strategy with search terms describing each relevant component of the PICO(T). Relevant elements of your PICO(T) question can be used to develop an initial list of keywords (including synonyms) to use in a database search. The most important parts of a PICO ... PICOT Questions Evidence-Based PICOT Questions Examples. PICOT Questions: Population: Bariatric adolescents considering or undergoing gastric bypass surgery.. Intervention: The nurse’s role as a primary member of the multidisciplinary team regarding perioperative care of the bariatric adolescent patient.The author’s goal in posing this PICO question was to determine whether enough evidence exists to support screening adolescents for depression using an appropriate screening tool. This PICO question itself facilitated the search strategy and guided the selection of key words. Search strategy. The author searched multiple databases, including ...About PICO; PICO's Limitations; Case Study. Case: Patient Education; P: Consider when choosing your patient/problem; I: Consider for your intervention; C: Consider for your comparison; O: Consider for your outcome; PICO: Putting it together; PICO Examples; Other Question Frameworks; ResourcesDiagnostic OR= (a/b)/ (c/d)=742.9. We would need to perform a test accuracy study to answer our question. The participants would get a mammography (index test) and a biopsy to determine the presence of breast cancer (reference test). Each test would yield a positive or negative test result. Preferably, all patients get both tests, without much ...Sep 15, 2022 · P: laboring women delivering in a hospital I: positions other than the lithotomy position C: lithotomy position O: decreased incidence of assisted deliveries In laboring women delivering in the hospital, do positions other than lithotomy position lead to a decreased incidence of assisted deliveries? Question: Should women give birth in the lithotomy position because its encourage from their doctors? Or is it more effective to deliver in other positions as their less likely to lead to delivers with forceps or a vacuum? Running head: NSG 410 PICOT RESEARCH QUESTION. References. DiFranco, J. T., & Curl, M. (2014). The author’s goal in posing this PICO question was to determine whether enough evidence exists to support screening adolescents for depression using an appropriate screening tool. This PICO question itself facilitated the search strategy and guided the selection of key words. Search strategy. The author searched multiple databases, including ...I = Interventions. C = Comparisons. O = Outcomes. Using the earlier example question, we can break it down into a PICO question like this: P = Patient or Problem (young children) I = Interventions (distractions during immunization) C = Comparisons (no distractions/standard care) O = Outcomes (lower pain scores) You may also hear some people use ...Jul 27, 2023 · You need to assess what reasonable clinical study population your patient could be part of. For example, if your patient is a 73 year old woman, "73 year old women" or "women in their 70s" is too specific because it is highly unlikely that clinical researchers would design a study that would exclusively enroll women in their 70s. Have two essential components: Example: What causes migraines? or How often should women over the age of 40 have a mammogram? A question root (who, what, when, etc.) with a verb A disorder, test, treatment, or other aspect of healthcare The background question is usually asked because of the need for basic information.2. Foreground questions are specific knowledge questions . that affect clinical decisions and ; include a broad range of biological, psychological, and sociological issues. Foreground questions are best suited to the PICO model as it captures the essential elements of your information need to help translate that question into a search query. To ...Application to PICO. The articles chosen for the analysis related to the PICO question: “In the second stage of labor, what is the effect of laboring down after complete cervical dilation on mother and baby compared with pushing before cervical dilatation is complete?” The population that wasDifferent types of clinical questions are suited to different syntaxes and phrasings, but all will clearly define the PICO elements. The definitions and frames below may be helpful for organizing your question: Intervention/Therapy. Questions addressing how a clinical issue, illness, or disability is treated.This section includes the evidence summaries for each key question. It incorporates a summary of the included review for PICO question 1 and the results of the primary reviews (PICO questions 2–6), other relevant evidence (specifically, related guidelines and systematic reviews) and a summary of the evidence-to-decision framework.100 useful pico questions for nursing research 1. Many toddlers are afraid of needles during vaccinations, is using toys as a distraction for the childrenâ&#x20AC;&#x2122;s pain response ...PICOT is a mnemonic resulting from the elements of clinical research. The PICOT process starts with a particular case, and the question is couched to develop an answer. A PICOT question helps you get the answer to your clinical question. It serves as a framework, prompting you to consider various aspects of the topic under investigation.The author’s goal in posing this PICO question was to determine whether enough evidence exists to support screening adolescents for depression using an appropriate screening tool. This PICO question itself facilitated the search strategy and guided the selection of key words. Search strategy. The author searched multiple databases, including ...Table 2.1, PICO questions for the recommendations in women (the general population of women ... Aug 31, 2023 · PICO is a formula used to develop a researchable clinical question. The purpose of a PICO question is to help breakdown a research question into smaller parts, making the evaluation of evidence more straightforward. Who is the patient or population? (Think demographics: age, sex, gender, race). What problem or disease or situation are you facing? When you formulate a PICO question, you are creating a formula that does several things: Focus the question by identifying the components or concepts in the question. Defines the concepts that will be used when performing a complex literature search. Used to ascertain which articles in a search retrieval best address the question.The framework is actually divided into four major elements. A good clinical question will address most, if not all, aspects of the PICO nursing questions. The following are the parameters defined by PICO (T) when it comes to designing of clinical questions: P: Patient, Problem, Population. I: Intervention.The word PICOT is a mnemonic derived from the elements of a clinical research question – patient, intervention, comparison, outcome and (sometimes) time. The PICOT process begins with a case scenario, and the question is phrased to elicit an answer. “The question needs to identify the patient or population we intend to study, the ...Nov 21, 2008 · My advice: set your question based upon what you are interested in answering. For example what if you were interested in knowing "How do side effects, both physical and psychological, effect women who have experienced treatment for cervical cancer.."-radiation therapy, sex drive/life, effects of ADL's etc... If you are planning to create a systematic review, it is usually best to start with a PICO style question, it provides structure and boundaries to the task. Let’s try: To search for the core topics discussed in your review, you are probably going to want to use a combination of approaches. You are probably going to need to use the subject ...Table 2.1, PICO questions for the recommendations in women (the general population of women ...The framework is actually divided into four major elements. A good clinical question will address most, if not all, aspects of the PICO. The following are the parameters defined by PICO (T) when it comes to designing of clinical questions: P: Patient, Problem, Population. I: Intervention.Appendix H. PICO tables. PICO tables were generated for each question defining the target population, interventions and comparators (where appropriate) and outcomes. These are presented with a summary of the searching activity for each question. Go to: A good PICO will be specific and define terms and outcomes if necessary. A good PICO will investigate something new in terms of diagnosis, etiology, therapy, harm, etc. A bad PICO is usually a background question disguised as a research question. For example, "what are the effects of Prilosec on patients taking immune suppressants" might seem ...Aug 17, 2023 · Once you have the components of your PICOT formula, you can frame your question in 6 different ways depending on the goal/target, the nursing practice problem, or the healthcare issue you are addressing. You can use these PICO formats as a template for asking PICOT questions. 1. Examining a Diagnosis. Feb 18, 2022 · The word PICOT is a mnemonic derived from the elements of a clinical research question – patient, intervention, comparison, outcome and (sometimes) time. The PICOT process begins with a case scenario, and the question is phrased to elicit an answer. “The question needs to identify the patient or population we intend to study, the ...
The PICO question in this paper seeked to answer the question: in adult patients without celiac disease or gluten sensitivities, is GF food correlated with higher type 2 diabetes or CVD risk? The question was underpinned by a research study showing an inverse relationship between gluten consumption and type 2 diabetes rates. . Wpm
Foreground questions look for answers to specific patients, problems, types of interventions, and clinical outcomes, and the PICO framework will work well with these questions. Use PICO to write a clear, researchable clinical question. The four elements of PICO break a research topic into searchable keywords and make locating evidence-based ...These are some best examples of PICOT questions for falls. 2) The Prognosis. These questions are used in the following scenarios. Used to determine the potential complications from a specific condition or the clinical course over a particular period. The following is an example of an intervention PICOT question:PICO Framework. Without a well-focused question, it can be very difficult and time consuming to identify appropriate resources and search for relevant evidence. Practitioners of Evidence-Based Practice (EBP) often use a specialized framework, called PICO, to form the question and facilitate the literature search. 1 PICO stands for:Sep 15, 2022 · P: laboring women delivering in a hospital I: positions other than the lithotomy position C: lithotomy position O: decreased incidence of assisted deliveries In laboring women delivering in the hospital, do positions other than lithotomy position lead to a decreased incidence of assisted deliveries? Question 1. Question 2. Question 3. Population. Children <6 years of age. AND. Diagnosed with ADHD or at risk for ADHD or diagnosed with DBD (including ODD and CD by DSM) ≥6 years of age (subjects <6 years are described in Question 1) Diagnosed with ADHD by the DSM or ICD criteria that was in use at the time of the study or of the publication. Sep 24, 2022 · An example of a picot question comparing two groups of people is: Do- (P) Women-(I) Compared to-(C) Men-(O) Have a greater risk for-(T) picot question: Do women, compared to men, have a greater risk for developing Alzheimer’s disease? This picot question is asking about the risk factors for Alzheimer’s disease. 25 Clinical Questions and PICO. The use of PICO is very relevant in the construction of your clinical questions. Evidence-based nursing assignments demand you to structure your research questions in accordance with the PICO framework. The PICO framework is divided into four major elements. These elements will help you frame the background ...Sep 6, 2023 · It is important to note that there are different types or categories of PICOT questions. The category of your question can at times dictate the types of evidence that you are searching for. Determine in which category your question would best fit. Use the template to help you word it succinctly and correctly. PICO Framework. Without a well-focused question, it can be very difficult and time consuming to identify appropriate resources and search for relevant evidence. Practitioners of Evidence-Based Practice (EBP) often use a specialized framework, called PICO, to form the question and facilitate the literature search. 1 PICO stands for:Below are examples of nursing related questions: Intervention/Effect/Therapy PICO Question: An example: In adult patients with total hip replacements (Patient population) how effective is early ambulation (Intervention of interest) compared to bed rest (Comparison intervention) on decreasing post-op DVTs (Outcome)? Note: The question may also ...Developing a Targeted Research Question. Examine your topic to identify the major concepts you need to conduct the best searches. Some useful ways to do this include: Background planning: think of the 5 W's and H for your topic: Who - are the stakeholders, population of interest, involved parties. What - are the issues, problems, needs.Mar 31, 2021 · Diagnostic OR= (a/b)/ (c/d)=742.9. We would need to perform a test accuracy study to answer our question. The participants would get a mammography (index test) and a biopsy to determine the presence of breast cancer (reference test). Each test would yield a positive or negative test result. Preferably, all patients get both tests, without much ... Jul 31, 2023 · Note: The question may also appear as: What is the effectiveness of early ambulation, compared to bed rest, on decreasing post-op DVTs in adult patients with total hip replacements. Meaning PICO Question: How do pregnant women (P) newly diagnosed with diabetes (I) experience reporting their blood sugar levels (O) to their healthcare providers? << Have two essential components: Example: What causes migraines? or How often should women over the age of 40 have a mammogram? A question root (who, what, when, etc.) with a verb; A disorder, test, treatment, or other aspect of healthcare; The background question is usually asked because of the need for basic information.Table 2.1, PICO questions for the recommendations in women (the general population of women ...Use the PICOT format to structure your literature search based on a clearly-stated, searchable clinical question. P = Patient Population. I = Intervention or area of Interest. C = Comparison or Control group. O = Outcome.The PICO question in this paper seeked to answer the question: in adult patients without celiac disease or gluten sensitivities, is GF food correlated with higher type 2 diabetes or CVD risk? The question was underpinned by a research study showing an inverse relationship between gluten consumption and type 2 diabetes rates.These questions bring together multiple concepts related to a specific clinical situation or research topic. They are typically divided into two categories: Qualitative Questions aim to discover meaning or gain an understanding of a phenomena. They ask about an individual's or population's experience of certain situations or circumstances.Formulate a PICO Question . Answerable PICO Question: In middle-aged adult females with hypertension, are beta blockers more effective than ACE inhibiters in controlling blood pressure? Image: "Dagstuhl 2008-02-01 - 37" by Nic's events is licensed under CC BY-SA 2.0Systematic Review: A systematic review tries to identify, appraise, select and synthesize all RCTs (randomized control trials) relevant to a specific clinical question. . Stringent guidelines are set in order to draw a conclusion about whether or not there is conclusive evidence about a specfic treatment or to.