Creating a focused clinical question is a key step in EBM.
This page provides information on the EBM process, how to use PICO(TT) to form a clinical question, and the hierarchy of evidence that can be used to answer the question.
*Adapted from model used on UNC/Duke EBM Tutorial available at http://www.hsl.unc.edu/Services/Tutorials/EBM/studies2.htm
Use the PICO(TT) Format to develop specific and answerable clinical questions.
Patient, Population, or Problem
What are the characteristics of the patient or population? What is the condition or disease you are interested in?
Intervention or Exposure
What do you want to do with this patient (e.g., treat, diagnose, observe)?
Comparison or Intervention (if appropriate)
What is the alternative to the intervention (e.g., placebo, different drug, surgery)?
O = Outcome
What are the relevant outcomes (e.g., morbidity, death, complications)?
Type of Clinical Question
Diagnosis, Etiology/Harm, Therapy, Prognosis, Prevention
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 http://libguides.hsl.washington.edu/content.php?pid=231619&sid=1931590
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.
|Type of Question||Type of Study/Methodology|
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 http://researchguides.uic.edu/content/php?pid=47981&sid=353409
University of Cincinnati Libraries
PO Box 210033 Cincinnati, Ohio 45221-0033
Contact Us | Staff Directory