Evidence-Based Practice combines the best research evidence (found in health sciences literature) with a practitioner's clinical knowledge and the patient's values and expectations to make informed clinical decisions. Since Evidence-Based Practice requires clear and well-built clinical questions, the PICO method is a framework used to formulate a clear, researchable clinical question. It's useful for those in the health sciences, as it helps break down a broad topic into specific components. PICO is an acronym that stands for:
Patient, Population, or Problem: Who or what is the primary focus of your research? This could be a specific group of people (e.g., adult smokers), a condition (such as type 2 diabetes), or a specific patient.
Intervention: What is the action, treatment, or exposure you're interested in? This could be a new drug, a specific therapy, or a preventative measure.
Comparison: What is the alternative to the intervention? This could be a standard treatment, a placebo, or no intervention at all.
Outcome: What are you hoping to measure or achieve? This could be a reduction in symptoms, an increase in quality of life, or a change in a specific health marker.
Forming a clinical question in terms of the specific patient problem will aid you in finding clinically relevant evidence in the literature. The PICO method is a format to help you define your question. Once you have formatted your question, you will translate it into a search strategy to be used in an appropriate database.
| P | Patient or Population or Problem | How would you describe a group of patients similar to yours? |
|---|---|---|
| I | Intervention | Which main intervention, prognosis, or exposure are you considering? |
| C | Comparison intervention, if appropriate | What is the alternative you are considering (if any)? |
| O | Outcome | What do you hope to achieve? |
Once you have a clear PICO question, you can use the elements as keywords for searching. This makes your literature search more efficient and precise, helping you find the most relevant and high-quality studies in databases like PubMed or CINAHL. Without a focused question, your search would likely yield thousands of irrelevant results.
Select the highest level of evidence possible when searching for sources related to your PICO question. The levels of evidence pyramid seen below demonstrates both the quality of evidence and the amount of evidence available. The quality of the evidence increases as you move up the pyramid, but the amount of evidence available decreases. You may not be able to find a study from the highest levels of the pyramid related to your topic.
After you find the studies, you can use the PICO framework again to critically appraise them. It helps you determine if the research you found is a good fit for your question by checking if the study's Population, Intervention, Comparison, and Outcome match those in your question. This ensures that you're only considering evidence that is directly applicable to the clinical problem at hand, which is crucial for making a sound, evidence-based decision.
