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Evidence-Based Clinical Practice Resources

This guide highlights evidence-based medicine (EBM) and evidence-based nursing (EBN) resources available at the UC Health Sciences Library.

EBM Process

This guide focuses on the second and third components of the EBM process.

  1. Assess the patient
  2. Ask focused clinical questions : Using PICO
  3. Acquire the best evidence : find the recommended level of evidence for the type of clinical question being asked. If that level is unavailable use the evidence pyramid to determine the next best option.
  4. Appraise the evidence critically
  5. Apply evidence to patient care


It is important to remember that when seeking evidence that not all evidence is equal. It is important to seek out the recommended study level as well as evaluate the evidence.

Focused Clinical Questions & PICO(TT)

Use the PICO(TT) Format to develop specific and answerable clinical questions.

PICO description
PICO Format Definition & Questions to Consider
P Patient, Population, or Problem
What are the characteristics of the patient or population? What is the condition or disease in which you are interested?
I Intervention or Exposure
What do you want to do with this patient (e.g., treat, diagnose, observe)?
C Comparison or Intervention (if appropriate)
What is the alternative to the intervention (e.g., placebo, different drug, surgery)?
O O = Outcome
What are the relevant outcomes (e.g., morbidity, death, complications)?
T Type of Clinical Question
Diagnosis, Etiology/Harm, Therapy, Prognosis, Prevention
T Type of Study Design to Answer the Question
What would be the best study design/methodology (Systematic review, RCT, cohort study, case control, etc.)

*Descriptions from the University of Washington Evidence-Based Practice LibGuide at


Knowing the Type of Clinical Question will help you determine the best type of study design. The table* below demonstrates the types of studies generally recommended to answer particular types of clinical questions.

Clinical Question Types
Type of Question Type of Study/Methodology
Diagnosis controlled trial
Therapy double-blind RCT, Systematic review / meta-analysis
Prognosis cohort studies, case control, case series
Harm/Etiology cohort studies, case control, case series
Prevention randomized controlled trial, cohort studies
Quality improvement Randomized controlled trials

*Table adapted from


PICO - Adapted to other Question Types
  For Diagnosis For Prognosis For Risk, etiology or harm
P Patient Patient Patient
I Test

Prognostic Factors

(Such as: disease state, comorbidity, or demographic factor)

Risk Factor
C Standard Absence of Prognostic Factors Absence of Risk Factors
O Outcome Outcome Outcome


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