One of the basic skills required for practicing EBP is developing a well-built clinical question. Theses questions need to be directly relevant to the patient or problem at hand and phrased in such a way as to facilitate the search for relevant and precise answers. PICO makes this process easier. It is an acronym/mnemonic for the important elements of a well-built clinical question. It also helps formulate the search strategy by identifying the key concepts that need to be in the article that can answer the question.
PICO or PICOTT:
P = PATIENT OR PROBLEM - How would you describe a group of patients similar to yours? What are the most important characteristics of the patient?
I = INTERVENTION, EXPOSURE, PROGNOSTIC FACTOR - What main intervention are you considering? What do you want to do with this patient?
C = COMPARISON - What is the main alternative being considered, if any?
O = OUTCOME - Include patient oriented outcomes (morbidity, mortality, quality of life, etc).
TYPE OF QUESTION - Identify the question scenario (Therapy / Diagnosis / Etiology / Prognosis)
TYPE OF STUDY - Identify study design to help answer question (Systematic review / RCT / cohort study / case controlled)
Primary Question Types
Other Question Types
From: Sackett, DL. Evidence-based medicine: how to practice and teach EBM.
Authors: Phillips R, Glasziou P.
Published in: Postgrad Med J. 2008
Abstract: This paper gives a practical account of why and how to learn to practice evidence based medicine while still in clinical training. It highlights practical benefits to learning the skills (such as passing exams, coping with information overload and helping patients), and explains how to manage each of the four essential steps (asking questions, acquiring information, appraising evidence, and applying the results). Key resources to give the trainee rapid access to evidence based answers are highlighted, as are efficient ways of keeping up to date with the emerging literature.
Resources for Evidence-Based Practice
Miner has a terrific list of resources for Evidence-Based Practice.
See the Evidence-based Practice Guide page
Videos about Evidence Based Practice
The final days of King Charles II
An interesting YouTube video titled: "Why we need evidence based medicine"
The video isn't terrific, but the audio is worth listening to - it's an historic account of how King Charles II was treated in accordance with the medical knowledge of the time.
Article: Evidence changes practice
A medical histories article on evidence-based medicine, titled: "From 'trust us, we're doctors' to the rise of evidence-based medicine"