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. 2006:2006:359-63.

Evaluation of PICO as a knowledge representation for clinical questions

Xiaoli Huang  1 , Jimmy Lin, Dina Demner-Fushman
Affiliations

Evaluation of PICO as a knowledge representation for clinical questions

Xiaoli Huang et al. AMIA Annu Symp Proc. 2006.

Abstract

The paradigm of evidence-based medicine (EBM) recommends that physicians formulate clinical questions in terms of the problem/population, intervention, comparison, and outcome. Together, these elements comprise a PICO frame. Although this framework was developed to facilitate the formulation of clinical queries, the ability of PICO structures to represent physicians' information needs has not been empirically investigated. This paper evaluates the adequacy and suitability of PICO frames as a knowledge representation by analyzing 59 real-world primary-care clinical questions. We discovered that only two questions in our corpus contain all four PICO elements, and that 37% of questions contain both intervention and outcome. Our study reveals prevalent structural patterns for the four types of clinical questions: therapy, diagnosis, prognosis, and etiology. We found that the PICO framework is primarily centered on therapy questions, and is less suitable for representing other types of clinical information needs. Challenges in mapping natural language questions into PICO structures are also discussed. Although we point out limitations of the PICO framework, our work as a whole reaffirms its value as a tool to assist physicians practicing EBM.

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References

    1. Ely JW, Osheroff JA, Chambliss ML, Ebell MH, Rosenbaum ME. Answering physicians’ clinical questions: Obstacles and potential solutions. J Am Med Inform Assoc. 2005 Mar–Apr;12(2):217–24. - PMC - PubMed
    1. Gorman PN, Helfand M. Information seeking in primary care: How physicians choose which clinical questions to pursue and which to leave unanswered. Med Decis Making. 1995 Apr–Jun;15(2):113–9. - PubMed
    1. Chambliss ML, Conley J. Answering clinical questions. J Fam Pract. 1996 Aug;43(2):140–144. - PubMed
    1. Currie LM, Graham M, Allen M, Bakken S, Patel V, Cimino JJ. Clinical information needs in context: an observational study of clinicians while using a clinical information system. AMIA Annu Symp Proc. 2003:190–4. - PMC - PubMed
    1. Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ. 1996 Jan 13;312(7023):71–2. - PMC - PubMed

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