After first identifying an information need, the next step in evidence-based practice is to re-frame the problem by posing a clearly stated and searchable question. EBP practitioners use a structure called PICO to advance their thoughts from fuzzy and generalized to crisp and precise.
PICO is a framework for structuring a clinical question by separating it into four components. Framing PICO helps you identify some of the keywords you will use in searching databases.
P = What are the significant characteristics of the patient or the population?
I = What intervention are you considering?
C = Are you considering another intervention as a comparison to the first?
O = What is the desired outcome of the intervention(s)?
(Time is sometimes a fifth element of PICO.)
(T) = How much time does it take for an intervention to reach an outcome?
Need a few good examples of PICO in action to get you started? The following websites take you through short, easy-to-follow examples on how to formulate good research questions using the PICO framework of Patient, Intervention, Comparison, and Outcomes:
PAY CLOSE ATTENTION: You will need to turn your PICO framework into a clinical research topic.
Although the PICO framework is an excellent framework to get at the root of a clinical problem, it is NOT a good format to search a database.
Let's look at this PICO example for a patient:
You may be tempted to find search terms with using the exact PICO terms, like this:
Unfortunately, searching for medical literature in a database isn't that specific. If so, you'd be looking only for a matching case study! Instead, you need to turn your PICO statement into a clinical research topic that you can search for.
In this case, you clinical research topic is:
And your search terms might look like this:
Here are a few search tips to keep in mind successful database searching, with PICO elements for your search terms:
Partially adapted from John Moritiz Library's EBP LibGuide.
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