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Ophthalmology: Creating a good clinical question

Analysing the scenario

The choice of which terms to enter for your search in any database, especially in PubMed, requires you to build what is known as a search strategy.

This entails

  • Finding the key concepts or intent of the search
  • Finding terms (eg. synonyms) for each key concept
    • Using a thesaurus such as MeSH will help to identify these synonyms, variant spellings, etc.
  • Formulating a search using Boolean logic (AND, OR)

Using the PICO formula may help to build a good search strategy


Why Use PICO?

  • To get the question clear in your mind
  • To identify the information you need to answer the question
  • To translate the question into searchable terms
  • To develop and refine your search approach 


Minutes spent properly formulating your question will save you hours in searching (and help you to get better marks in your IR OSCE stations!).



Constructing a Clinical Question using PICO

The PICO model will help you to construct your "foreground" clinical questions.

  • P stands for patient/population/problem or condition
  • I is the relevant intervention, exposure ot test that you want to use in relation to the patient/population or problem
  • C is the comparative (alternative) intervention, exposure or test, if there is one
  • O represents the outcome, or what you are most concerned about happening
    • Positive Outcomes: Prevention of illness or improvement in health
    • Negative Outcomes: Side effects/Adverse effects


Mrs Martin presents with complaint of difficult swallowing for the past 3 weeks. In addition she experiences pain when swallowing. The need is to find the answer to what is the cause of the difficulty with swallowing, pain on swallowing, condition of oral mucosa, teeth and gums, palate or the pharynx and tongue and pharyngeal movements etc. 

Subject Guide

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Nonkuthalo Ngcakaza
Mrs Nonkuthalo Ngcakaza-Mchunu
Senior Librarian
College of Health Sciences
University of KwaZulu-Natal
Medical School Campus
Tel: 031-260 4766
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