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Using the PICO framework to improve clinical PubMed searches

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For 21st century health care and the practice of evidence-based medicine (EBM), ubiquitous access to clinical information as well as knowledge-based resources to answer clinical issues is required, as is the availability of knowledge-based resources. Despite this, many questions remain unsolved due to a lack of skills in the formulation of questions, the creation of effective search techniques, and the accessing of databases to determine the best levels of evidence.

Three Different Interfaces

Using three different interfaces for the PubMed search system, this randomized trial was developed as a pilot research to determine whether search results were relevant to the search query. Two of the search interfaces made use of an unique framework known as PICO, which was created to focus clinical inquiries and prompt for the type of publication or query asked in the search. 

Regular PubMed Interface

The third interface was the regular PubMed interface, which was easily accessible over the World Wide Web. Interns and residents participating in an inpatient general medicine rotation at an academic medical center in the United States were used as study participants. Thirty-one subjects were randomly assigned to one of three interfaces and instructed to search PubMed for a collection of relevant articles that would provide a solution to each of the three clinical queries.

Using a precision score, which was calculated as the ratio of the number of relevant or gold standard articles found in a result set to the total number of articles found in that set, the search results were assessed to be successful or unsuccessful.The EBM method begins with the formulation of a well-focused question, which is the first and possibly most crucial phase. With no clearly defined inquiry, it can be extremely difficult and time consuming to discover appropriate resources and conduct a thorough search for relevant evidence to support your claim.

Practitioners of EBM Frequently

Practitioners of EBM frequently employ a specific structure, known as the PICO framework, to formulate the query and assist the search for relevant literature. PICO is an abbreviation that stands for Patient Problem, Intervention, Comparison, and Result. The PICO framework can be extended to include information on the type of question being answered (treatment, diagnosis, prognosis, harm, and so on), as well as the optimal type of study design for that particular topic.

This is known as the 皮秒 framework. When used in conjunction with a clinical question, this framework aids the clinician in articulating the critical components of a clinical question that are most relevant to the patient and in facilitating the searching process by highlighting the main concepts for an effective search strategy.

This pilot study was unable to demonstrate a statistically significant difference in the search protocols because of the modest number of searches conducted for each arm. Although there was a trend towards more precision, this needs to be examined further in a bigger study in order to evaluate whether PICO can increase the relevancy of search results.

Final Thought

The number of relevant citations retrieved was compared to the total number of articles retrieved. Each clinical question’s article was chosen by the study team. The paper had to address the specific clinical question, including patient, intervention, and result, and use the best study methodology for the question.

For example, a therapeutic question required a randomized controlled trial, but a prognosis question required a prospective cohort research. Each question required two PubMed searches. These two and a third researcher chose pertinent articles from the search results. Another researcher re-examined the results and resolved any discrepancies.

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