LibGuides: The EBM Medical Literature Search: ASK: PICO

ASK your Question

PICO is used in Evidence Based Medicine (EBM) to help frame the focused research question from a topic, or perhaps a very broad initial question. This helps create a strategy for searching the health science and medical literature, ensuring you search for articles relevant to your question and not your overall topic.

PICO Steps

When presented with a case or research topic, PICO helps formulate your clinical/research question. It is useful to note all keywords and possible synonyms so that you can easily plug them into a PICO question format (see the "formulating your question" box.) Keywords and Synonyms will also act as the base for both your simple and advance search strategies.

TIP: Please note that not all parts of PICO will be present in your question.

Alternative formats are PICOT, PICOTT, or PICOM. The additional letters are below.

(T) Time
(T) Type of question
(T) Type of study
(M) Methodology

PICO Blank Work Chart
To access this editable Word doc on your iPad, look for an “open in” option in the lower right corner. Save in a drive or open in Word.

Now that you have your PICO chart filled, You can formulate your question.

(See the "PICO Practice" box for scenarios to practice creating a PICO chart and formulating a question.)

What type of question are you asking?

Therapy: effectiveness/risk of a certain treatment

Diagnosis: accuracy/usefulness of a diagnostic test/tool; application to a specific patient

Prognosis: Probable outcome, progression, or survivability of a disease or condition; likelihood of occurrence

Etiology/Harm: Cause or risk factors for a disease or condition; Questions about the harmful effect of an intervention or exposure on a patient.

Determining what type of PICO question you are asking will help you determine what study types you should search for within the literature. Use filter options when searching to help move down the pyramid in sections.

RCTs and controlled clinical trials help to answer treatment questions and diagnosis questions. if there aren't any RCTs or controlled clinical trials, move down the pyramid to the next best option.
Cohort Studies help answer prognosis questions and etiology/harm questions.
When you cannot find a cohort study to answer your prognosis or etiology/harm question, look for a Case Control Study.
When you cannot find a cohort study or a case control study to answer your prognosis or etiology. harm question, look for a Case Series or Case Report.

Need a refresher on study types? Click the guide below, which provides a tab for study design overview and additional resources.

Evidence Based Medicine
by Michelle Keba Knecht Last Updated Feb 23, 2024 12 views this year

Cochrane Library This link opens in a new window
The Cochrane Library is a collection of six databases that contain different types of independent evidence to inform healthcare decision making, and a seventh database that provides information about groups in The Cochrane Collaboration: The Cochrane Central Registry of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Database of Abstracts of Review of Effects, Health Technology Assessment, and NHS Economic Evaluation Database.
Embase This link opens in a new window
Embase's extensive journal and conference coverage, together with in-depth drug indexing and daily updates, supports tracking and precise retrieval of drug and disease information.
Trip This link opens in a new window
Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care.

Practice PICO Scenarios

Jimmy is a five year old with a large wart on his hand. His previous warts have been “burned off” using cryotherapy, a treatment he found painful. His mother read on the internet about using duct tape to remove warts and wants to know if it will work.

Keywords

P: ___________________________________

I: ____________________________________

C: ___________________________________

O: ___________________________________

Synonym(s)

P: ____________________________________

I: ____________________________________

C: ____________________________________

O: ____________________________________

Is this a Diagnosis, Therapy, Prognosis, Etiology/harm, or Prevention question? (See the "Formulating Your Question" box for phrasing help.)

Clinical Question:

________________________________________

________________________________________?

Keywords

P: Five year old; Child.

I: Cryotherapy

C: Duct tape

O: Wart removal

Synonym(s)

P: Children; Adolescent; Youth;

I: Cryotherapies; Cold Therapy; cold therapies

O: Verrucas

Is this a Diagnosis, Therapy, Prognosis, Etiology/harm, or Prevention question? (See the "Formulating Your Question" box for phrasing help)

Clinical Question:

In children, what is the effect of duct tape on warts compared with cryotherapy?

A hearing test is an important component of the physical exam of elderly patients. Dr. Smith knows that some clinicians simply ask patients about their hearing ability and others use a tuning fork to test it, but he thinks that a simple whispered voice test is very accurate. Challenged to back this up with evidence at morning report tomorrow, he has come to you to help do a literature search.

Keywords

P: ___________________________________

I: ____________________________________

C: ___________________________________

O: ___________________________________

Synonym(s)

P: ____________________________________

I: ____________________________________

C: ____________________________________

O: ____________________________________

Is this a Diagnosis, Therapy, Prognosis, Etiology/harm, or Prevention question? (See the "Formulating Your Question" box for phrasing help)

Clinical Question:

________________________________________

________________________________________?

Keywords

P: Elderly patients

I: Voice test

C: Tuning fork

O: Test hearing loss

Synonym(s)

P: Aged; Adults; hearing impaired; hearing impairment

I: Whisper test; whisper voice test

C: Weber test; Rinne test

O: Audiometry

Is this a Diagnosis, Therapy, Prognosis, Etiology/harm, or Prevention question? (See the "Formulating Your Question" box for phrasing help)

Clinical Question:

Is a voice test more accurate in diagnosing elderly patients compared with a tuning fork for testing hearing loss?

Further practice can be completed by viewing Dartmouth's full list of PICO scenarios.

Additional PICO Scenarios 2011

Scenarios credited to Dartmouth Biomedical Libraries.

Dartmouth EBM Guide: https://researchguides.dartmouth.edu/evidence-basedmedicine

Last updated on Apr 23, 2024 3:12 PM