In evidence-based medicine practice, the PICO Model has been developed as a technique for formulating a patient-specific clinical question. Before initiating this model begin by asking yourself to formulate the clinical question by defining the problem. Oxman has identified four clinical “questions”(2).

• Therapy

• Efficacy and safety of treatment

• Is the treatment effective and not harmful?

• Articles about therapy are typically randomized, doubled-blind studies as they would provide the strongest level of evidence

• Diagnosis/Screening

• Precision and accuracy of diagnostic tests

• Preventing false positive and not missing existing conditions

• Articles about diagnosis are typically controlled trials

• Prognosis

• Power of predictive markers

• Determine who has increased risk for condition

• Long Term Outcome for patient

• Articles about prognosis are typically cohort studies.  As they identify the presence of and determine the increased risk associated with a factor of contention. 

• Etiology (Harm/Benefits)

• Assess treatment benefit to patient

• Risks of treatment

• Articles about etiology are typically cohort studies meaning exposed and nonexposed groups of patients.  Randomized controlled trials if there is a relationship between an agent and an adverse event

A full description of the PICO Model is discussed in the Evidence Based Practice section.