Pre-Clerkship Library Resources

The information resources you need for your first two years of medical school.

Literature Search Strategies

Think about your core concepts. Keep search terms simple at first, and pay attention to keywords and other terms you see referenced in relevant articles. Check the MeSH terms/subject headings in databases to find relevant terms. You can use new terms you find as you read to revise your search.

PICO Framework

PICO: Patient/Problem, Intervention, Comparison, Outcome
Framework	Think About	Example
Patient Problem (Population)	What are the most important characteristics of the patient or population? Include primary problem, comorbidities, or demographics (age, gender, ethnicity, socioeconomic status).	Adult male with high blood pressure; mostly sedentary lifestyle
Intervention/Exposure	What intervention is being considered (medication, exercise, education, rest)? Or what exposure is under review?	Increased physical activity
Comparison/Control	Is there a comparison treatment (another medication, different therapy, or no treatment)?	No increase in physical activity
Outcome	What desired effect do you want to measure or achieve? What are you trying to improve or affect?	Sustained lowering of blood pressure to normal range

Writing Your Question

Break it down into each section
Patient Problem or Population	Intervention/Exposure	Comparison/Control	Outcome
children with obesity	Community recreation activities	compared to educational programs on lifestyle changes	reduce risk of Diabetes Mellitus
adults	who binge drink	none (or compared with those who don't)	have a higher risk for mortality
in the United States	does climate change		increase the spread of vector-borne diseases

PICO worksheet: the well-built clinical question

PEO Framework

PEO is useful for qualitative research. PEO questions identify three concepts: population, exposure, and outcome
PEO	Definition	Example
Population	Who is my question focused on?	mothers
Exposure	What is the issue I'm interested in?	postnatal depression
Outcome	What, in relation to the issue, do I want to examine?	daily living experiences

Research question: What are the daily living experiences of mothers with postnatal depression?

Question and Study Types

Type of Question	Type of Study
Therapy - determine the effect of interventions on patient outcomes. For a disease or condition, will the treatment do more good than harm?	Systematic Review RCT
Prognosis - Estimating a patient's likely course over time due to factors other than interventions. What are the likely complications of a particular disease or condition?	RCT Cohort Study Case-Control Study
Harm/Etiology - What are the effects of potentially harmful agents of patient-important outcomes. Does this exposure cause the disease?	Case-Control study Cohort Study RCT- depending on the intervention, some may be unethical to deliberately expose patients to harm
Diagnosis - Establishing accuracy of a diagnostic test to differentiate between those with and without a target condition or disease.	Prospective, blind comparison to a gold standard Cross-sectional Study
Prevention - How to reduce the change of a disease by identifying and modifying risk factors. How to diagnose early with screening. Will the chosen preventative measure eliminate or reduce the chances of developing the disease or condition?	Systematic Review RCT