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Medical Students: Year 2

Information for students in year 2 in the MD Program. Includes tutorials, eResouces, citation guides, and research assistance

The Well-Built, Patient-Oriented Clinical Question

PICO is a mnemonic used to describe the four elements of a good clinical foreground question. The PICO model is used in Evidence-Based Medicine to assist in formulating a searchable clinical question relating to therapy, diagnosis, prognosis, etiology or harm. 

Patient scenario: A middle aged woman presented with exacerbation of her usual pattern of migraine. She asked specifically about whether riboflavin might help as she had heard from a friend that it helped prevent migraine. Together you formulate the question, in patients with frequent migraines, is riboflavin effective in the reduction of migraine frequency or severity?

Question Components Your Patient Scenario

P - Patient or Population

Describe the most important characteristics of the patient.

(e.g., age, disease/condition, sex, ethnicity?)

Patients with migraine                                                                                                                                                                                                     

I - Intervention; Prognostic Factor; Exposure

Describe the main intervention.

(e.g., drug or other treatment, diagnostic screening test)

riboflavin

C - Comparison (if appropriate)

Describe the main alternative being considered.

(e.g., placebo, standard therapy, no treatment, the gold standard)

 

O - Outcome

Describe what you're trying to accomplish, measure, improve, affect.

(e.g., reduced mortality or morbidity, reduced length of stay, improved memory, accurate and timely diagnosis. You may wish to add time factors.)

Reduced frequency and/or severity of migraine

Since this is a question about a therapeutic intervention, a randomized controlled trial would be ideal to provide an answer. 

See this link for a full description of the approach taken to answer this question. More practice questions are available in the Evidence Based Medicine Toolbox developed by the McMaster Knowledge Translation Program. https://ebm-tools.knowledgetranslation.net/resource