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Evidence-Based Medicine (EBM)

Guide to EBM practices and resources

Asking the Right Question

During the ASSESS portion of a clinical scenario, clinicians should ask a number of relevant questions. These include several background queries into the patient's history, the condition, and the medical subjects being considered. Questions like these seek to gather information about things, inquiring into the how, what, why, when, and where of the case being presented. Such queries can be more appropriately answered by topical sources like textbooks, clinical monographs, or point-of-care tools like UpToDate or DynaMed.

Asking more foreground questions allows clinicians to arrive at a relevant clinical question targeting a specific patient and problem. This also enables them to incorporate a well-situated intervention and sometimes a comparison that can lead to a specific outcome. For any given case, there will be a single question arrived at that requires clinicians to identify these variables. In EBM, this will generally be done using the PICO research framework. The PICO acronym described below is the most effective method of approaching a clinical scenario by ASKing the right question.

P - Patient, Problem, Population

I - Intervention

C - Comparison

O - Outcome

Clinical Categories

The PICO designation is important for identifying variables associated with a clinical scenario, yet it is not the only research framework. PICO and other frameworks consider the concepts involved in a case, the terminology of which can be further broken down into synonyms useful for searching relevant literature. Furthermore, the relevant question, how it is framed and what it consists of, help position the question within certain clinical categories--usually therapy/prevention, diagnosis, prognosis, and etiology/harm. These specify the type of approach needed and correlate to study designs to focus the search around.


- Patient/Problem/Population
I - Intervention
C - Comparison
O - Outcome


P - Patient/Problem/Population
I - Index Test
R - Reference Test
D - Diagnosis of Interest

P- Patient/Problem/Population
F - Prognostic Factors/Exposure
O - Outcome


P- Patient/Problem/Population
E - Exposure(s)
O - Outcome

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