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Evidence-Based Resources: Formulating an Answerable Question

How to Formulate Your Question

Organizing your question before you start searching for an answer will save you searching time and effort.  There is a structured format for asking questions in the evidence-based medicine process.  The question format is called PICO.  Using this simple system will help you to create a "well-built" question. 

PICO stands for P (the patient problem or population), I (the intervention), C (comparison to another intervention, if any) and O (outcome or outcomes desired). Here are some questions to ask that might help in creating the PICO:

P:  What is the patient or patient group in question?  What is the chief complaint or main concern or disease?  What are the important characteristics of the patient e.g., if gender will affect the disease or treatment include this but if it would not be a factor, do not include it in your Pico.   What is the age, race, etc. if that impacts your results.  Usually age is an important factor.  Usually gender and race are not.   

I: What is the intervention, treatment,  medication, procedure, etc.  that you want to explore?

C:  What is the alternative that you are considering?  Sometimes there is no alternative.  If this is the case, skip C. 

O: What do you want to accomplish or affect?  Do you want to improve functioning, relieve a symptom, cure a disease, control a condition?

PICO Worksheet

Here is a PICO worksheet that you can copy and use for formulating your well-built question:

THE WELL BUILT CLINICAL QUESTION

 

 

Components of a good question:

 

Your Question:

 

 

PATIENT OR PROBLEM:

How would you describe a group

of patients similar to you? What

are the most important

characteristics of the patient?

 

 

 

 

INTERVENTION, EXPOSURE,

PROGNOSTIC FACTOR:

What main intervention are you

considering? What do you want to

do with this patient?

 

 

 

 

COMPARISON:

What is the main alternative being

considered, if any?

 

 

 

 

OUTCOME

What are you trying to accomplish,

measure, improve or affect?

 

 

 

 

The well-built clinical question is:

 

 

 

 

 

 

More Resources for Formulating Questions

Centre for Evidence Based Medicine at Oxford's Asking Focused Questions.

Schardt C, Adams MB, Owens T, Keitz S, Fontelo P: Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Medical Informatics and Decision Making 2007, 7:16.