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Responsible Literature Searching: P.I.C.O. Model
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P.I.C.O. Model for Clinical Questions
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Articulation of a clinical question in terms of its four anatomic parts—Problem/Population, Intervention, Comparison, and Outcome (PICO)—facilitates searching for a precise answer in the literature. Empirical studies have shown that the use of PICO frames:
Improves the specificity and clarity of clinical problems Elicits more information during pre-search reference interviews Leads to more complex search strategies Yields more precise search results
P I C O |
Ask yourself: |
Population
(patient/condition) |
- How would you describe a group of patients similar to yours?
- What are the most important characteristics of the patient?
- This may include the primary problem, disease, or co-existing conditions.
- Sometimes the sex, age or race of a patient might be relevant to the diagnosis or treatment of a disease.
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Intervention
(drug, procedure, diagnostic test, exposure) |
- Which main intervention, prognostic factor, or exposure are you considering?
- What do you want to do for the patient? Prescribe a drug?
Order a test? Order surgery?
- What factor may influence the prognosis of the patient? Age? Co-existing problems?
- What was the patient exposed to? Asbestos? Cigarette smoke?
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Comparison |
- What is the main alternative to compare with the intervention?
- Are you trying to decide between two drugs, a drug and no medication or placebo, or two diagnostic tests?
- Your clinical question does not always need a specific comparison.
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Outcome |
- What can you hope to accomplish, measure, improve or affect?
- What are you trying to do for the patient? Relieve or eliminate the symptoms?
- Reduce the number of adverse events? Improve function or test scores?
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