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Evidence Based Practice


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 
 Keep in mind that if you are having a difficult time converting your topic into a question, you may not know enough about it to perform a search! Use some of the Background Knowledge resources in the left column to round out your understanding.


Take the following sample question:

In a 20 year old male athlete, is wearing a face mask more effective than warm-up exercise to reduce the effects of exercise-induced asthma?

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

  • Patient - 20 year old male athlete (athletes)
  • Intervention - wearing a face mask (masks)
  • Comparison -  warm-up exercise (warm-up exercise)
  • Outcome - improved exercise-induced asthma (exercise-induced asthma)

In the next section, "Identifying the Best Evidence," you'll learn more about different levels of evidence and the different types of clinical questions.


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