PICO Worksheet and Search Strategy

Clinical Scenario

In morning surgery you see a new mother who has been taking St John's Wort because

she is concerned she has post natal depression. She is breast feeding and is concerned

about the effect St John's Wort may have upon her baby. You decide to perform a

literature search for evidence that St. John's Wort is safe to use during breast feeding and

also to research the efficacy of St John's Wort in the treatment of post natal depression.

1. Define your question using PICO by identifying: Problem, Intervention, Comparison

and Outcomes.

Patient/Problem: new mother

breast feeding

post-natal depression

Intervention: St John’s Wort

Comparison: no St John’s Wort

anti-depressants

Outcome: effectiveness of St John’s Wort

safety of St John’s Wort

2. Write out your question - your question should be used to help establish your search

strategy.

Are there any adverse effects upon a breast feeding baby when the baby's mother is

taking St John's Wort?

Other questions:

How effective is St John's Wort in the treatment of post-natal depression?

Do other anti-depressive drugs have an adverse effect on a breast feeding baby?

3. List main topics and alternate terms from your PICO question that can be used

for your search

Now we have formulated a question, the next step is to breakdown this question or

statement into its key concepts.

Our example:

Are there any adverse effects upon a breast feeding baby when the baby's mother is

taking St John's Wort?

Keywords or Concepts Synonyms (alternate terms)

St John’s Wort Saint John's Wort

hypericum

breast feeding lactation

side effects adverse reactions

harmful effects

4. Your search statement

Combine your search terms using the Boolean operators AND, OR, NOT.

For our example:

st john’s wort OR saint john’s wort OR hypericum

AND

breast feeding OR lactation

AND

side effects OR adverse reactions

5. Scope

List your inclusion criteria –gender, age, year of publication, language

List irrelevant terms that you may want to exclude in your search