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A clinical question needs to be directly relevant to the patient or problem at hand. It helps to phrase it in such a way as to get the best possible results from the evidence. PICO(T) makes this process easier. It is a mnemonic for categorizing the important parts of a well-built clinical question. It also helps to lay the foundation for your search strategy by identifying the key concepts that need to be in the article that can answer your question.
Population/ Patient/ Problem – who are you researching?
Intervention – treatment you’re looking into. Examples include medications, exercise, therapies, diet
Comparison – standard treatment or alternate intervention
Outcome – must be measurable so it can be meaningfully compared
Time (optional) – what is your timeframe?
The clinical question helps you determine what to look for – what to include and what to exclude. Determine your question before beginning your search. Once you have your question, use it for search terms including similar or synonymous terms, for example immunization and vaccine. Remember to use main points for your search, not little ones - blood pressure, not vital signs.
When you do your actual search, combine terms for different parts of your question, but not all four. It is recommended to look up the intervention or comparison, not both in your search, at least to start. Using too many search terms may limit your search unnecessarily. Aim for at least a couple pages of results. If you have over a thousand results, use limiters and additional search terms to narrow it down. Part of seeking clinical research is taking the articles you find in different searches and comparing them to each other.
Disclaimer
The nursing library liaisons are not health sciences professionals so we cannot determine the accuracy or validity of PICO questions from nursing students. We recommend contacting your nursing faculty or graduate assistant feedback. The Nursing Liaison Librarians can certainly help you with organizing your PICO questions as well as look for articles to address your formatted PICO question.
Determining Levels of Evidence
Evidence-Based Practice is hierarchical and uses a rating system to determine the level of evidence. One of the more well-known systems is the one developed by Johns Hopkins. The level of evidence is directly influenced by the research study design, rigor and applicability to the population are significant factors. The stronger the evidence, the more confidence the results will lead to best practice.
The Johns Hopkins EBP model uses 3 ratings for the level of scientific research evidence
The level determination is based on the research meeting the study design requirements (Dang et al., 2021, p. 146-7).
You will use the Research Appraisal Tool (Appendix E) along with the Evidence Level and Quality Guide (Appendix D) to analyze and appraise research studies. (Tools linked below.)
Nonresearch evidence is covered in Levels IV and V.
Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines. Sigma Theta Tau.
AccessMedicine features core textbooks for medical education, with additional news and resources. Includes captions.
Note: we don't have complete access to all the case files.
AccessPediatrics provides access to text books, atlases, videos, and other resources related to pediatrics, information necessary for completing evaluations, diagnoses, and case management decisions, as well as for pursuing research or self-assessment and board review. Includes captions. Limited to 10 simultaneous users.
ClinicalKey is a peer reviewed, evidence based point-of-care clinical information service for physicians and healthcare professionals. It provides a unique combination of electronic books, medical journals, First Consult, Procedures Consult, practice guidelines, clinical trials, MEDLINE, and abstracts from PubMed. Does not include captions or transcripts.
Note: ClinicalKey policy states that no more than 50% of book content (or 1/2 total chapters) may be downloaded and stored in a 24-hour period or the user will be locked out and administrator notified
DynaMed is an evidence-based information resource used by physicians around the world to answer clinical questions quickly and easily. DynaMed includes thousands of topics covering emergency medicine, cardiology, oncology, infectious diseases, pediatrics, obstetrics and gynecology and much more.
Note: if you get an error message, close the browser and try accessing the site again.
As of June 30, 2024, UIC will no longer have an institutional subscription to DynaMed. More info.
Physicians around the world use Isabel to help construct or broaden a differential diagnosis. By entering the information normally captured in a patient workup, Isabel provides physicians with a list of possible diagnoses to help them construct their thinking and make an accurate final diagnosis quickly and easily at the point of care.
Trip is a clinical search engine designed to find high quality research evidence to support clinical practice and care. It simultaneously searches evidence-based sources of systematic reviews, practice guidelines, MEDLINE's Clinical Queries, medical image databases, e-textbooks, and patient information.
Note: You must download the Cisco Anyconnect VPN to access Trip Pro Database from off campus. Here are instructions for Windows, MAC, Linux, Android, and IOS users:
Windows
MacOS
Linux
Android
iOS
UpToDate is an online, peer-reviewed clinical decision support tool with topic reviews covering symptoms, tests and diagnosis, and treatment options for over 8,500 conditions.
Note: In order to maintain uninterrupted access to the UpToDate mobile app, you must verify your continued affiliation with UIC. You can do so by logging in to UpToDate with your UIC NetID and Password via the proxy link above or via remote VPN and then signing in with your Personal UpToDate account once every 90 days. For more guidance, visit the UIC Library Mobile Medicine Guide on the UpToDate Mobile App.
VisualDx is a diagnostic clinical decision support system designed to enhance diagnostic accuracy, aid therapeutic decisions, and improve patient safety.
Note: users can also sign up for a FREE VisualDx Personal Account by clicking the Quick Registration Link below while on your institution Wi-Fi network or VPN. VisualDX Institutional Login
Access provided courtesy of the College of Medicine.
Trip is a clinical search engine designed to find high quality research evidence to support clinical practice and care. It simultaneously searches evidence-based sources of systematic reviews, practice guidelines, MEDLINE's Clinical Queries, medical image databases, e-textbooks, and patient information.
Note: You must download the Cisco Anyconnect VPN to access Trip Pro Database from off campus. Here are instructions for Windows, MAC, Linux, Android, and IOS users:
Windows
MacOS
Linux
Android
iOS