Physical Therapy

One way of focusing your question is by using the PICO format (you may also see PICO(T) or PICOTT). PICO includes several factors that, when searched together, comprise a well-built clinical question. It includes:

• Patient, Population, and/or Problem - Who or what is your question about?
• Intervention, Prognostic Factor, or Exposure - How do you want to treat your patient?
• Comparison - What is the standard of care in this situation? What other treatments have been used in past trials?
• Outcome - What is the intended result?

You can clarify your intended results at the outset with additional, optional factors:

• Time - Duration of study, duration between intervention and outcome
• Type of Question - Therapy, Etiology, Diagnosis, Prognosis, Prevention
• Type of Study - Meta-Analysis, Systematic Review, Randomized Controlled Trial, Cohort Study, Case Control Study 

Take the following sample question:

In patients with chronic low back pain, is cognitive functional therapy more effective than manual therapy in reducing pain intensity and disability.

This example covers all elements of PICO, and provides us four distinct elements to convert into search terms:

• Patient - chronic low back pain
• Intervention - cognitive functional therapy
• Comparison -  manual therapy
• Outcome - pain intensity, disability

To convert these PICO elements into a search, visualize each as its own category and identify potential synonyms for each. Think about other ways researchers might describe each concept and use the MeSH Thesaurus to identify parallel topics, separated with the Boolean Operator OR.

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