PICO Examples
Your patient has a history of blood clots and after they came in to your clinic with right calf discomfort and
tightness, you're concerned about DVT. You remember reading about the limitations of duplex ultrasound
and calfveins, and are wondering if a d-dimer assay can help you rule out DVT more accurately.
P- adults
I- d-dimer assay
C- ultrasound
O- more accurate diagnosis of DVT
Question: Is d‐dimer assay more accurate at ruling out deep vein thrombosis compared to ultrasound?
Your female patient is concerned about her risk of developing breast cancer. Her friend was recently
diagnosed, and mentioned that her smoking might have been a factor. Your patient and her wife have lived
together for 10 years, and while she doesn't smoke, her partner does. Is she at an increased risk over
someone without daily exposure to second-hand smoke?
P- female non smokers w/ daily second hand smoke exposure
I-
C- female non smokers w/o daily smoke exposure
O- develop breast cancer
T- over ten years
Question: Are female non-smokers with daily exposure to second-hand smoke over a period of ten years or greater
more likely to develop breast cancer when compared with female non-smokers without daily exposure to second
hand smoke?
Your patient, who owns a bakery, recently participated in their employer's wellness program. Their BMI is
within a normal range, but they have a family history of obesity, and are concerned about the impact carbs
may have on maintaining a healthy weight.
P- pts w/ family history of obesity
I- carb intake; specific diet?
C-
O- keeping BMI below 25; healthy weight management
Question: Does dietary carbohydrate intake influence healthy weight maintenance (BMI <25) in patients who have family history of obesity
(BMI >30)?
Tom is 55 years old and has smoked one pack of cigarettes a day for the last 30 years. He is ready to
quit, and is wondering about his options. He has heard of a medication called bupropion, but is also
familiar with nicotine replacement therapy options such as patches, lozenges, and gum. Tom wants to
know which option will work best to help him quit and abstain from smoking again in the future.
Patient/problem/population: mid-50s male with a 30 pack-year history of smoking
Intervention: bupropion
Comparison intervention: nicotine replacement therapy
Outcome: long-term abstinence from smoking
Janet is 42 years old and just had her first mammogram. She does not have a history of breast cancer
in her family, and she has heard from her friends that she doesn’t need to have a mammogram every
year, only every three years because of new guidelines. She wants to know if she has to come back
every year for a mammogram, or if she can make an appointment every three years.
Patient/problem/population: woman in her 40s with no family history of breast cancer
Intervention: mammograms every three years
Comparison: yearly mammograms
Outcome: early detection of breast cancer
you have a patient who has difficulty exercising due to COPD and you wonder if pursed lip breathing
techniques may improve their endurance.
P = patients with COPD
I = pursed lip breathing
C = regular breathing
O = improved exercise endurance
"In patients with COPD, does using pursed lip breathing, as compared to regular breathing, improve
exercise endurance?"
You are working with a recent stroke patient who is having balance issues and you are considering
using virtual reality in their therapy.
P = recent stroke, balance issues
I = virtual reality
C = no virtual reality
O = improved balance
"In recent stroke patients, how does using virtual reality affect or improve balance?"
Your patient is a recent veteran who is experiencing insomnia and you wonder how effective
sleep restriction therapy might be in improving her sleep patterns.
P = insomnia
I = sleep restriction therapy
C = no therapy
O = improved sleep patterns
"In recent veterans with insomnia, how effective is sleep restriction therapy at improving sleep
patterns?"
A clinician wants you to undertake a literature search for him. He is interested in finding out
whether ibuprofen is better than paracetamol at reducing fever in young children
P Young children with fever
I Ibuprofen
C Paracetamol
O Reducing Fever
Is an MRI scan more sensitive/specific than bone scintigraphy at diagnosing scaphoid fractures in the
elderly?
Elderly
P
Scaphoid fracture
MRI scan
I
Bone scintigraphy
C
Sensitivity/specificity
O
Can ultrasound accurately detect obstructive biliary disease in adults with acute abdominal pain?
Adults with acute abdominal pain Obstructive
P biliary disease
Ultrasound
I
NOT APPLICABLE
C
Accurate diagnosis (as measured by sensitivity
O and specificity of test)
How effective is vitamin 3D in preventing relapses in patients with multiple sclerosis?
P Multiple sclerosis
I Vitamin 3D
C No comparison
O Preventing relapses
How does laparoscopic colectomy compare with open surgery in terms of cost-effectiveness, recurrence
and survival rates in patients with colon cancer?
P Colon Cancer
I Laparoscopic colectomy
C Open Surgery
O Cost-effectiveness, recurrence
and survival rates
How effective is vitamin 3D in preventing relapses in patients with multiple sclerosis?
P Multiple sclerosis
I Vitamin 3D
C No comparison
O Preventing relapses
