Library Guides: Pharmacy: Barry and Judy Silverman College of Pharmacy guide: PICO explanation

Identify main concepts

Use the mnemonic device PICO to identify the main concepts from the patient's case:

PICO tutorial
This short tutorial will introduce you to each of the PICO components and gives you an opportunity to practice with two clinical questions.

PICO for patient case example:

P	Patient, population, and/or problem	Patient xyz
I	Intervention, exposure, or prognostic factor	Intervention xyz
C	Comparison or control	Comparison (maybe)
O	Outcome	Outcome xyz

Identifying the type of question you are trying to answer will help you focus/phrase your PICO question and determine the best study design to answer that question.

The type of question will help you determine which study design is best.

To limit your search to a specific study design, use the database's filters/limits. If the database does not have study design filters/limits, add keywords to your search (e.g., lung cancer AND cohort).

Types of clinical questions and study types

How to select treatment to offer patients that do more good than harm and that are worth the efforts and costs of using them.

Best type of study to answer therapy questions:
- Randomized controlled trial (RCT) --> cohort* --> control* --> case series
- RCT is the best type of study, but if there is no RCT then look for the next best available type of study.
To retrieve case-control and cohort studies, add the following to your search:
- * "Case-Control Studies" [Mesh]
- * "Cohort Studies." [Mesh]

Source: MUSC Libraries: https://musc.libguides.com/ebd/StudyDesign

How to select and interpret diagnostic tests in order to confirm or exclude a diagnosis, based on considering their specificity, sensitivity, likelihood ratios, expense, safety, etc.

Best type of study to answer diagnosis questions:
- prospective, blind comparison to a gold standard

Source: MUSC Libraries: https://musc.libguides.com/ebd/StudyDesign

How to estimate the patient's likely clinical course over time and anticipate likely complications of disease.

Best type of study to answer prognosis questions:
- Cohort study* --> Case Control Study*--> Case Series

To retrieve case-control and cohort studies, add the following to your search:
- * "Case-Control Studies" [Mesh]
- * "Cohort Studies." [Mesh]

Source: MUSC Libraries: https://musc.libguides.com/ebd/StudyDesign

How to identify causes for disease.

Best type of study to answer etiology/harm questions:
- Randomized controlled trial (RCT) -->Cohort Study*-->Case-Control Study* --> Case Series

To retrieve case-control and cohort studies, add the following to your search:
- * "Case-Control Studies" [Mesh]
- * "Cohort Studies." [Mesh]

Source: MUSC Libraries: https://musc.libguides.com/ebd/StudyDesign

How to reduce the chance of disease by identifying and modifying risk factors and how to diagnose early by screening.

Best type of study to answer prevention questions:
- Randomized controlled trial (RCT) --> cohort study* --> case-control*--> case series

To retrieve case-control and cohort studies, add the following to your search:
- * "Case-Control Studies" [MeSH]
- * "Cohort Studies." [MeSH]

Source: MUSC Libraries: https://musc.libguides.com/ebd/StudyDesign