Grand Rounds Final: PICO/PECO and
Levels of Evidence
What are the 5 steps of Evidence-Based Practice?
-Ask
-Aquire
-Appraise
-Apply
-Audit
What kind of question does the PICO/PECO question need to be?
-Answerable
What are the 4 components of the PICO/PECO question?
P: Patient/Population/Problem (Among)
I/E: Intervention/Exposure (does)
C: Comparison (versus)
O: Outcomes (affect)
Describe the patient/problem
-Must be very specific
-What patient population are we looking to answer with the question?
(Over 65, advanced perio, diabetes)
Describe the intervention
What is the main intervention or therapy you wish to consider?
-Exposure to disease, diagnostic test, prognostic factor, treatment, patient
perception, risk factor
-The intervention is defined, the more relevant the evidence
Describe the comparison
What are you comparing the intervention with?
(standard of care, placebo, absence of a risk factor)
This is not always needed!!
Describe the outcomes
-What outcomes are you expecting to see as a result of the intervention?
, (risk of disease, accuracy of diagnosis, rate of occurrence of adverse outcomes, reduced
infection rate)
Outcomes need to be measurable!
What part of the PICO question is not always necessary?
-Comparison
What must the outcomes be?
-Measurable
What are 3 characteristics of answerable questions?
-Short
-Sharp
-Clear
It is only asking ONE thing
Are background questions PICO questions?
-NO
-They are very broad and usually only have one or two PICO components
What are some resources for background questions?
What are foreground questions?
-Contains multiple elements of PICO
-Addresses specificity
What are resources for foreground questions?
-PubMed
-TRIP database
Levels of Evidence
What are the 5 steps of Evidence-Based Practice?
-Ask
-Aquire
-Appraise
-Apply
-Audit
What kind of question does the PICO/PECO question need to be?
-Answerable
What are the 4 components of the PICO/PECO question?
P: Patient/Population/Problem (Among)
I/E: Intervention/Exposure (does)
C: Comparison (versus)
O: Outcomes (affect)
Describe the patient/problem
-Must be very specific
-What patient population are we looking to answer with the question?
(Over 65, advanced perio, diabetes)
Describe the intervention
What is the main intervention or therapy you wish to consider?
-Exposure to disease, diagnostic test, prognostic factor, treatment, patient
perception, risk factor
-The intervention is defined, the more relevant the evidence
Describe the comparison
What are you comparing the intervention with?
(standard of care, placebo, absence of a risk factor)
This is not always needed!!
Describe the outcomes
-What outcomes are you expecting to see as a result of the intervention?
, (risk of disease, accuracy of diagnosis, rate of occurrence of adverse outcomes, reduced
infection rate)
Outcomes need to be measurable!
What part of the PICO question is not always necessary?
-Comparison
What must the outcomes be?
-Measurable
What are 3 characteristics of answerable questions?
-Short
-Sharp
-Clear
It is only asking ONE thing
Are background questions PICO questions?
-NO
-They are very broad and usually only have one or two PICO components
What are some resources for background questions?
What are foreground questions?
-Contains multiple elements of PICO
-Addresses specificity
What are resources for foreground questions?
-PubMed
-TRIP database
