Seven Steps to the Perfect PICO Search
This "White Paper" explores how using a PICO-based search strategy can help you find evidence to answer practice questions.
Download the paper using the link below.
White Paper from EBSCO Health | CINAHL.
What are the characteristics of the patient or population?
What is the condition or disease you are interested in?
Intervention or exposure
What do you want to do with this patient (e.g. treat, diagnose, observe)?
Comparison
What is the alternative to the intervention (e.g. placebo, different drug, surgery)?
Outcome
What are the relevant outcomes (e.g. morbidity, death, complications)?
Start your search broadly, beginning with only the P and the I elements.
Do not include the O element in your initial search unless you must, ie., if the number of results from the P and I search, is too huge to peruse.
Scope out the databases you plan to use. Find a few relevant studies and examine the complete references to identify two items:
2. Keywords in the articles' abstracts.
Add the relevant terms to your Search.
Search for one term at a time. After you have searched for each P element, connect those related terms with the Boolean "OR." Repeat for the I element.
To link the P and I elements of your question, combine the complete P results set and the complete I results set with the Boolean "AND."
Limit the results by study design, working your way down the evidence pyramid.
If need be, search for your question's O element and link it with the P and I elements.
The clinical question is:
In patients with type 2 diabetes and obesity, is bariatric surgery more effective than standard medical therapy at increasing the probability of remission of diabetes?
It is a therapy question and the best evidence would be a randomized controlled trial (RCT). If we found numerous RCTs, then we might want to look for a systematic review.
|
PICO |
Clinical Question |
Search Strategy |
|
Patient/Problem |
Obese, diabetes type 2 |
Diabetes type 2, obesity |
|
Intervention |
Stomach stapling (gastric bypass surgery; bariatric surgery) |
Bariatric surgery |
|
Comparison |
Standard medical care |
|
|
Outcome |
Remission of diabetes; weight loss; mortality |
|
|
Type of question |
Therapy |
|
|
Type of study |
RCT |
Clinical query – therapy/narrow Or Limit to randomized controlled trial as publication type |
Type of question and the type of study are the two elements of a well-built clinical question. This can be helpful in focusing the question and determining the most appropriate type of evidence or study.
| Most common type of questions: | Type of study: |
| Diagnosis how to select and interpret diagnostic tests |
prospective, blind comparison to a gold standard or cross-sectional |
| Therapy how to select treatments that do more good than harm and that are worth the efforts and costs of using them |
randomized controlled trial > cohort study |
| Prognosis how to estimate the patient’s likely clinical course over time (based on factors other than the intervention) and anticipate likely complications of disease |
cohort study > case control > case series |
| Etiology how to identify causes for disease (including iatrogenic forms) |
cohort > case control > case series |