LibGuides: Orthopedic Surgery Residency Resource Guide: PICO

The Clinical Question

MOST COMMON TYPE OF CLINICAL QUESTIONS:

THERAPY	determining the effect of interventions on patient-important outcomes
DIAGNOSIS	establishing the power of a test to differentiate between those with and without a target condition or disease
HARM	ascertaining the effects of potentially harmful agents on patient-important outcomes
PROGNOSIS	estimating a patient's future course

4 ELEMENTS OF THE CLINICAL QUESTION (PICO) - use for therapy questions	QUESTION/STUDY DESIGN

PICO Worksheet	PICO Tutorial

Patient

What are their most important characteristics?

Primary problem
Disease state
Co-existing condition

Describe your patient specifically:

Sex
Age
Ethnicity
Socioeconomic factors

ALWAYS include this piece in your search.

Intervention

What do you want to do for the patient?

Order a test
Prescribe a drug
Order a procedure

Other considerations:

Main intervention
Prognostic factors
Exposures

Almost always include this piece in your search.

Comparison

What is the alternate intervention, if any?

A different drug
No medication
A Placebo
A different test
A different procedure

It is less common to include this piece in a search.

Outcome

What are you hoping to achieve, measure, or change for the patient?

Alleviate symptoms
Improve test results
Reduce adverse events
Improve function

Could also be the result NOT desired.

Sometimes include this piece in your search.

Example Questions

1. Does Constraint-induced Aphasia Therapy (intervention) improve aphasia (outcome) in stroke patients (patient)?

2. In kindergarteners (patient), is individual pull-out treatment (intervention) more effective than group pull-out treatment (comparison) for improving articulation disorders (outcome)?