Users' Guides to the Medical Literature: a Manual for Evidence-Based Clinical Practice, 3E by PICO is an evidence-informed practice tool that helps you clearly frame clinical questions. It's also a useful technique when you need to evaluate a research study. Librarians have always stressed the importance of thinking through what you need to find before beginning to search; the more specific you can be about what you're looking for, the easier it will be to find it.
This brief video will walk you through the steps. (Courtesy of Physiotherapy Assn. of British Columbia)
You don't need to enter all of the elements from your clinical question into the database search box; in many cases, information from the P and I of your PICO may be sufficient. Sometimes your PICO can be a PICO(s). The "s" stands for "study," used when it is clear what type of study type (clinical trial, systematic review, etc.) your topic or assignment requires.
Some aspects of your search, such as publication date, study type, age and gender, can be captured with the database's Limits or Filters feature, but you may need to broaden the limits you set if you retrieve too few hits, e.g. use a longer date range or a wider age group.
The next box will show you a database search example for PubMed, using PICO. As you work through it, you'll become more familiar with how to:
summarize a clinical scenario in PICO format,
derive a clinical question from the PICO, and
determine which elements of the clinical question are best to include in your search query.
Your patient is experiencing pregnancy-related nausea and you're wondering if using ginger might help with her symptoms.
| Patient Population (or Problem) | Intervention (or Exposure) | Comparison (if known) | Outcome Measure(s) |
| Pregnant women | Ginger | Better or worse results in nausea for pregnant women not using ginger |
Amount of nausea felt |
Is ginger effective in alleviating nausea in pregnant women?
In the example below, official PubMed subject headings (MeSH terms) are capitalized (but capital letters aren't necessary in running searches).
Example PubMed search query:
Morning Sickness AND Ginger - 35 results
Since I retrieved so few search results, I may want to expand my search to include another possible nausea reducing method (an additional I in PICO) and amend my search to look like this:
Morning Sickness AND (Ginger OR Acupuncture Therapy) - 75 results
Explanation of PubMed search queries:
Search terms: Morning Sickness, Ginger and Acupuncture Therapy are MeSH terms (Medline subject headings).
Parentheses tell PubMed how to run the search, i.e. first find citations with either or both terms in parentheses, and then combine the two sets.
Filters: I didn't use filters in this search, but PubMed's filters appear on the left sidebar after you run the search; click Show more filters at the bottom of the left sidebar if you don't see the ones you need. Often filters are the best place to specify age and/or gender in your search.
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