Background questions are needed to acquire basic or general knowledge about a topic. These are the who, what, why, when, where, and how questions. For example: What are the major complications of diabetes? Who should be tested for osteoporosis? When should children get the Varicella vaccine? How do cancer cells grow and spread?
Foreground questions seek information to help make a clinical decision focused on a particular patient or clinical situation.
To answer foreground questions, use PICO(T)
In order to practice evidence-based medicine, you need to be able to formulate a good clinical question. It is helpful to use the PICO(T) format. With PICO(T), you divide your topic into its key concepts, formulate your clinical question, and develop a search strategy.
P - Patient or Problem
I - Intervention, Exposure, or Prognostic Factor
C - Comparison, if any
O - Outcome
T - Type of Question
PICO (+TT) is a mnemonic used to describe the four elements of a good clinical question. It stands for:
To make the search for evidence easier, you may want to add TT to the PICO formula. The T's stand for:
Primary Question Types
Other Question Types
Select words from the PICOTT concepts to guide the development of a PubMed search. Remember: