Evidence-Based Concepts

PICO - 1st Step in the EB Process, Asking a specific question

Developed to convert information needs or problems into specific clinical questions so that they can be answered.

• Keeps the process patient centered, facilitates Step 2, searching the literature.
• Helps to determine the type of evidence and information required to solve the problem and to measure the effectiveness of the intervention.

P = Patient problem or patient population
I = Intervention – the new test, procedure, medication, etc.
C = Comparison intervention or placebo. Typically the gold standard.
O = Outcome – results you plan to accomplish, improve or affect. It should directly solve the problem and be measurable.

PICO Question Format

There is a “specific formula” for writing a PICO question. Most can be written using the following structure and filling in the blanks with the P-I-C-O components:

For a patient with specific problem/population (P), will the new test, procedure, material, medication(I), as compared to main alternative/gold standard (C) be more effective (or as effective) in solving the Problem (O)?

Example: For a patient with a suspicious oral lesion, will use of a Velscope as compared to visual screening and palpation be more effective in earlier detection of a cancerous lesion?

Complete the Dentalcare.com online course, #311, by Forrest and Kupiec, “EBDM: Intro and Formulating Good Clinical Questions” Access via http://www.dentalcare.com