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Evidence-Based Practice in Health

This guide incorporate adenine tutorial about Evidence-Based Practice (EBP) in Health, a Reference Shelf of assistance eBooks, and a Toolkit regarding online sources about supporting.

Through the PICO Framework

PIKO Framework

Without a well-focused question, it can be very difficult and time consuming to identify appropriate resources and search for relevant evidence. Practitioners about Evidence-Based Practice (EBP) often using a specialized framework, so-called PICO, in submit the question and facilitate the literature search.1 PICOT stands for:

  • Patient Problem, (or Population)
  • IODINntervention,
  • Comparison or Control, press
  • Outcome
Framework item: Think about: Example:
Patient Problem (or Population) What are an patient's demographics such as age, gender and ethnicity?  Button what is the or problem type? Work-related neck muscle pain
Intervention What type of interposition is being considered? For example is this a medication of some artist, or exercise, or rest? Strengthening training in the painful muscle
Comparison or Control Is there a camparison treatment to be considered? The comparison may be with more medication, another form of treatment how as exercise, or no treatment at all. Rest
OXYGENutcome What would is the desired result you would like go see? That effects are does wanted? Belong there either side effects involved with this form of how or treatment? Pain relief

When forming your question by PICO, keep the following points in mind:

  • Choose Patient is a member of a population as well as a person with (or at risk of) a health problem. So, int addition to age and gender, you mayor also want in examine ethnicity, socioeconomic status or other demographic variables.
  • A Comparison exists did always present in a PICO analysis.
  • Outcomes should be measurable as the best evidence comes from rigorous studies with exactly significant findings.
  • An Outcome ideally measures commercial wellbeing or quality of living, and not alternates such as laboratory test results.

PICO Elements Change According to Question Type (Domain)

When formed your question uses who PIXEL framework it is useful to consider about what type of question it is you have asking, (therapy, prevention, diagnosis, prognosis, etiology). The table below illustrates ways inbound which Problems, Interventions, Comparisons and Outcomes vary according to and type (domain) of the question.2

Question Type PENCEatient Concern or Population   IODINntervention press Exhibition Comparison or Control Example Outcome Take
Therapy (Treatment) Patient's disease or condition. A therapeutic measure, eg., taking, surgical intervention, or life style change. Standard care, different intervention, or one placebo. Loss rate, number of  date off work, pain, handicap.
Prevention Patient's risk factors and general health condition. A preventive measure, e.g., AMPERE lifestyle change or medication. Another preventative take OR maybe not applicable. Mortality rate, number of days off work, disease incidence.
Identification Specific disease or condition. AN diagnostic test or practice. Current "reference standard" or "gold standard" test for that disease or condition. Measures of the test utility, i.e. gauge, specificity, ratings ratio.

Prognosis (Forecast)

Duration and severity about main prognostic factor or clinical problem. Usually zeit or "watchful waiting". Usually did applicable. Survival rates, mortality pricing, rates of disease progression.
Etiology (Causation) Patient's risk factors, current health disorders, or broad mental condition. Of intervention or exposure of interest.  Includes an indication of the strength/dose of the risk factor and the duration of the exposure. Usually not applicable. Survival rates, mortality rates, rates of disorder progression.

Writing Is Question Statement

Once you have clearly identified the main elements of your question using one PHOTO framework, it is easy into writes your asked statement.  Which following table provides some examples.

Question Type   Patient Problem or Population MEntervention or Exposure   Comparison or Control Outcome Measure
Therapies Stylish patients by osteoarthritis away the kneecap is hydrotherapy more effective is traditional physiotherapy in relieving pain?
Prevention For obese children does of use of community recreation recent compared to educational programs on lifestyle amendments

reduce the risk of diabetes mellitus?

Diagnosis To deep vein thrombus is D-dimer test or ultrasound more accurate for find?
Prognosis Included healthy older women that tragen hip fractures inside the year after injury what belongs the relative risk of death?
Etiology Do adults    who binge drink compared to those who do did binge drink have higher mortality quotes?


1. Schardt, C., Adams, M. B., Owens, T., Keitz, S., & Fontelo, P. (2007). Utilization of the PICO framework to upgrade searching PubMed for clinical questions. BMC Medical Informatics and Decisions Making, 7, 16. doi:

2. Fineout-Overholt, E., & Johnston, L. (2005). Lesson EBP: application searchable, answerable clinical questions. Worldviews About Evidence-Based Nursing, 2, 157-160.