Evidence Based Practice: An Introduction: PICO

An introduction to what evidence based practice is and how medical researchers can, and should, utilize it.

The Clinical Question

MOST COMMON TYPE OF CLINICAL QUESTIONS:

THERAPY	determining the effect of interventions on patient-important outcomes
DIAGNOSIS	establishing the power of a test to differentiate between those with and without a target condition or disease
HARM	ascertaining the effects of potentially harmful agents on patient-important outcomes
PROGNOSIS	estimating a patient's future course

4 ELEMENTS OF THE CLINICAL QUESTION (PICO) - use for therapy questions	QUESTION/STUDY DESIGN

PICO Worksheet

Patient

What are their most important characteristics?

primary problem
disease state
co-existing condition

Describe your patient specifically:

Sex
Age
Ethnicity
Socioeconomic factors

Intervention

What do you want to do for the patient?

Order a test
Prescribe a drug
Order a procedure

Other considerations:

Main intervention
Prognostic factors
Exposures

Comparison

What is the alternate intervention, if any?

A different drug
No medication
A Placebo
A different test
A different procedure

Outcome

What are you hoping to achieve, measure, or change for the patient?

Alleviate symptoms
Improve test results
Reduce adverse events
Improve function

Could also be the result NOT desired.

Examples

1. Does hand washing (intervention) reduce (outcome) hospital-acquired infection (problem)?

2. Is vitamin C supplementation (intervention) as effective as Zinc supplementation (comparison) in reducing the length of a cold (outcome) in adult females (patient)?

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