Evidence-based Decision Making: Introduction and Formulating Good Clinical Questions
Course Number: 311
Structuring the PICO Question
After understanding the elements of PICO and identifying each PICO component, you are now ready to structure the PICO question for Nathan’s case. The same exact terms/wording used for each PICO component, is used to construct the PICO question. The formula for writing the Question is:
For a patient with ______(P)_______, will ______(I)______ as compared to ____(C)______ increase/decrease be as or more effective in _______(O)______?
The PICO question for Nathan is then written as:
"For a patient with erosive tooth wear (P), will Sensodyne Pronamel® (a sodium fluoride toothpaste with potassium nitrate) (I), as compared to Crest Pro Health (a stannous fluoride toothpaste) (C), be more effective in preventing erosive tooth wear (O)?"
Following the PICO Worksheet (Table 5), you would then identify the type of question and study, and then list any additional terms or phrases related to the already identified P, I, C, and O. By generating these words, alternative key terms are identified that facilitate finding evidence to answer your question, Step 2, conducting a computerized search with maximum efficiency. For example, key terms that could be used in the search are: erosive tooth wear, tooth erosion, stannous fluoride, sodium fluoride with potassium nitrate, Sensodyne Pronamel® toothpaste or dentifrice, Crest Pro Health toothpaste or dentifrice. An example of a completed PICO Worksheet for Nathan Baker’s case is shown in Table 5.
Table 5. PICO Worksheet for Mr. Baker’s Case.
©2016 SA Miller, JL Forrest, PICO Worksheet, National Center for Dental Hygiene Research & Practice.