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WHSL Clinical Questions using PubMed: PICO

The first in a series of evidence-based medicine guides

Constructing a Clinical Question using PICO

The PICO model will help you to construct your "foreground" clinical questions.

  • P stands for patient/population/problem or condition
  • I is the relevant intervention, exposure ot test that you want to use in relation to the patient/population or problem
  • C is the comparative (alternative) intervention, exposure or test, if there is one
  • O represents the outcome, or what you are most concerned about happening
    • Positive Outcomes: Prevention of illness or improvement in health
    • Negative Outcomes: Side effects/Adverse effects

Using all Four Facets

Note: It is not always necessary to include all  four facets (components) in your PICO search statement, especially if you can find suitable MeSH terms to use in your search. By using prognosis in your Clinical Query search on binge drinking, for example, you will automatically include the prognosis for long-term mortalilty, as well as other outcomes. Sometimes your search will yield too few results if your search strategy is too specific.

However, you should minimally include P and I to begin with when searching under Clinical Queries in PubMed.

Example

Using the PICO model, formulate a clinical question for the following scenario:

Scenario: The Health and Wellness Clinic sees many first-year students who suffer badly from the after-effects of excessive alcohol consumption. The clinic staff want to warn students and parents about the long-term effects of binge drinking.

Clinical Question: Does adolescent binge drinking affect long term mortality?  

P: [adolescent] binge drinking

I:  no drinking/abstinence

C: [drinking]

O: long term mortality