Using the PICO model

to formulate

a search question

This guide was taken from a presentation done by Jane Willson

Assistant Librarian

Newham University Hospital NHS Trust

6th September 2007

What is PICO?

• A useful model to help structure an answerable question

• Used to formulate clinical questions

• Breaks down the question into four key elements

The PICO model

• Patient, Population, Problem

• Intervention

• Comparison

• Outcome

Patient, Population, Problem

• Patient or patient group (gender, race, age)

• Disease or condition

• Stage of the illness

• Care setting

Intervention

• Type of treatment (drug, procedure, therapy)

• Intervention level (dosage, frequency)

• Stage of intervention (preventative, early, advanced)

• Delivery (who delivers the intervention? where?)

Comparison

• Alternative interventions (standard treatment, placebo,

another intervention)

• There may not always be a comparison

Outcome

• The outcome or effects you are interested in, for

example

– Improvement of symptoms, healing

– Side effects

– Improved quality of life

– Cost effectiveness and benefits for the service provider

Remember…

• Including more search terms will narrow your search

– Use for very specific questions and larger databases to make

number of results more manageable

• For a broader search, less specific details are needed

– Use for broader questions and smaller databases which bring

back fewer results

Identifying the key concepts

• Example search scenario:

What evidence is there to support maggot therapy for the

treatment of pressure ulcers rather than conventional

debridement therapies?

• Identify the concepts :

What evidence is there to support maggot therapy for

the treatment of pressure ulcers rather than

conventional debridement therapies?

Using the PICO model

• P Pressure ulcers (problem)

• I Maggot therapy (proposed intervention)

• C Conventional debridement therapies(comparative treatment)

• O Wound healing (outcome)

References

• Booth, A. (2004) “Formulating answerable questions” in Booth, A. and Brice, A. Evidence-based practice for information professionals: a handbook. Facet Publishing. pp. 61-70

• Nordenstrom, J. (2007) Evidence-based medicine in Sherlock Holmes’ footsteps. Blackwell Publishing.

• Zakowski, L., Seibert, C. and VanEyck, S. (2004) “Evidence-based medicine: answering questions of diagnosis.” Clinical Medicine & Research, 2(1) pp. 63-69.