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Literature Search

  1. Pubmed
    1. Clinical queries
      1.  Postherpetic neuralgia AND antidepressants
      2.  Postherpetic neuralgia AND (lidocaine OR capsaicin)
      3.  Advanced: history #1 AND #2
      4. Advanced: history #1 OR #2
      5. Systematic review (more general) postherpetic neuralgia AND treatment
    2. CAM on Pubmed (limits: CAM, arthritis, kava and insomnia)
    3. My NCBI
  2. Cochrane Review
  3. ACP journal club
  4. National Clearinghouse:
    1. Guideline syntheses
    2. What’s new
  5. TRIP
    1. Labs (new) search wizard PICO
    2. Related search

Formulating Patient Centered Questions

Defining a clinical question in terms of the specific patient problem aids the searcher in finding clinically relevant evidence in the literature.

P.I.C.O. Model for Clinical Questions

Patient, Population, or Problem

How would I describe a group of patients similar to mine?

Intervention, Prognostic Factor, or Exposure

Which main intervention, prognostic factor, or exposure am I considering?

Comparison or Intervention (if appropriate)

What is the main alternative to compare with the intervention?

Outcome you would like to measure or achieve

What can I hope to accomplish, measure, improve or affect?

What type of question are you asking?

Diagnosis, Etiology, Therapy, Prognosis, Prevention, Harm

Type of study you want to find

What would be the best study design/methodology?








Patient or Problem

Intervention (a cause, prognostic factor, treatment)

Comparison Intervention


Tips for Building

Starting with your patient ask, “How would I describe a group of patients similar to mine?” Balance precision with brevity.

Ask “Which main intervention am I considering”


Be Specific.

Ask “What is the main alternative to compare with the intervention?”


Be specific.

Ask”what can I hope to accomplish?” or “What could this exposure really affect?”



“in patients with heart failure from dilated cardiomyopathy who are in sinus rhythm…

“would adding anticoagulation with warfarin to standard heart failure therapy…”

“…when compared with standard therapy alone…”

“…lead to lower mortality or morbidity form thromboembolism, I s this enough to be worth the increased risk of bleeding?