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What Is Your Question?

Before starting an EBM search, you must have a clear idea on the type of information you are looking for. What type of intervention, if any, do you want to explore?

One good way of doing this is to apply a set of questions to the clinical problem. This is called PICO, which stands for:

P	Patient or population	Describes patient (age, sex, race, past medical history, etc.)	A 50 year old woman with a family history of breast cancer
I	Intervention	What happens or is to be done; treatment, diagnostic test, exposure, screening	Hormone replacement therapy
C	Comparison	Compared to what? Nothing, placebo, gold standard, another intervention	Placebo
O	Outcomes (preferably clinical)	What is the effect of the intervention? (Be specific: mortality after a particular time period, hospitalizations).	Prevention of Alzheimer's Disease

Before starting a search, write down the answers to these PICO questions. The key elements in the answers will become search terms in your on-line search and the additional information will help you when analyzing the studies you find.

It often helps to form these elements in the form of a question:

AMONG 50-year old women with a family history of breast cancer DOES hormone replacement therapy AS COMPARED TO placebo reduce the risk of Alzheimer's Disease?

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