Evidence-Based Medicine: A FINER PICO Analysis

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Asking the right question is fundamental to any serious research endeavor. Developing a cogent research question specifies the trajectory for the planning, analysis, and reporting of a research study and its dissemination in grant proposals and scientific journals.1,2 The cognitive leap required to move a developing idea into a logical research question and then conclusively to a testable hypothesis is a useful and iterative process.1,2 A convenient prompt for defining the characteristics of good research questions that ultimately leads to a good research plan has been presented by Cummings et al.1,2 The prompt is based on the mnemonic “FINER”: feasible, interesting, novel, ethical, and relevant.1-3
Fortunately, the evolution of evidence-based medicine has provided systematic tools to simplify the formulation of interrogatives that serve as the foundation of a real clinical research question. One of the fundamentals in the evidence-based medicine toolkit is known by the acronym “PICO,”1–4 which represents diagnostic questions based on 4 areas of knowledge and action: patient or problem; intervention, cause, or prognosis; comparison or control; and outcome. This evidence-based method is designed to make a valid, successful decision based on the skills and knowledge of the clinician, and incorporating the values of the patient is also an important distinction.
The PICO acronym is a framework for asking cogent research questions or important clinical questions for an individual patient or a group of patients. Asking the right question is crucial, but it is especially important when patient care or research is involved. In addition, it is critical to know what types of questions to ask.
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