Social Work 553: Stoops: Home

There are several PICO question types. For today, we will focus on the following.

• Therapy or Intervention: how to select treatments that do more good than harm and that are worth the efforts and costs of using them.
• Diagnosis or Diagnostic Test: how to select and interpret diagnostic tests to confirm or exclude a diagnosis, considering factors including precision, accuracy, acceptability, expense, safety, etc.
• Prognosis: how to estimate a patient's likely clinical course over time due to factors other than interventions
• Prevention: how to reduce the chance of disease/injury by identifying and modifying risk factors and how to diagnose disease/injury early by screening
• Etiology: how to identify causes for disease/injury 

Below are example structures for these questions types.

Therapy or Intervention

In_______________, what is the effect of ________________on _______________ (compared with _________________)?

Example:

In people with ankle instability, what is the effect of balance training on improving function (compared with no balance training)?

Diagnosis or Diagnostic Test

Are (Is) ________________ more accurate in diagnosing _______________ (compared with ____________)?

Example:

Is isokinetic dynamometry more accurate in diagnosing muscle strength after injury compared with manual muscle testing?

Prognosis

Does ____________ influence ______________ in patients who have _____________?

Examples:

Does vitamin D supplementation influence healing in people who have internally fixated fractures?

Prevention

For ___________ does the use of _________________ reduce the future risk of ____________ (compared with ______________)?

Example: 

For overhead athletes, does kinesiotaping reduce the future risk of injuries to the shoulder (compared with no taping)?

Etiology

Are ______________ who have _______________ at ______________ risk for/of ____________ (compared with _____________)?

Examples: 

Are adult women who have hypothyroidism at increased risk for reduced range of motion (compared to adult women without hypothyroidism)?

Content adapted from St. Catherine University Library's Physical Therapy guide by Cindy Graham, licensed CC BY-NC-SA and Duke University Medical Center Library & Archives' Evidence-Based Practice guide, licensed CC BY-NC-SA.

After developing your PICO question, generate your keywords or search terms. You may not use all elements of your PICO question in your search and should instead focus on the key concepts. Focus on your P (patient, population, problem) and your I (intervention or treatment). Think of synonyms for your keywords to improve the effectiveness of your search.

Generally, you will want to start with 2 to 4 search terms. You can combine your search terms with the Boolean operators AND, OR, and NOT.

AND: All search terms are present in search results. Ex. adults AND aged

OR: Any of the search terms are present in the search results (OR gets you more). Ex. adults OR aged

NOT: One of the search terms is present in the results, but not the other(s). Ex. adults NOT aged

If you are searching for a phrase, put the phrase in quotation marks to ensure the phrase in its entirety is searched. 

Simple Searches

Clinical question: 

In adults with a femoral shaft fracture (P), what is the effect of early weight-bearing activities (I) on the patient's gait (O)?

Search terms:

"femoral shaft fracture" AND weight-bearing AND gait

Complex Searches

Searches get more complex when you have multiple synonyms you want to include in your search. Synonyms should be grouped in parentheses and separated by the Boolean operator OR. Use AND to connect grouped search terms.

Clinical question:

In teenagers with shoulder injuries (P), what are current rehabilitation protocols (I)?

Search terms:

(teenager OR adolescent OR young adult) AND "shoulder injuries" AND rehabilitation

Content adapted from St. Catherine University Library's Physical Therapy guide by Cindy Graham, licensed CC BY-NC-SA.