PICO.vet is designed to help veterinary clinicians, researchers, librarians and others build a well-structured and focused clinical question that interactively searches the biomedical literature. Search terms are refined to support veterinary medicine when compared with the more widely known PICO models (see below) developed for human medicine.
PICO stands for Patient, Population and/or Problem, Intervention, Comparison Intervention and Outcome. PICO.vet is actually a PICOTT+ builder. The "T's" represent "Question Type" (e.g., questions about etiology, diagnosis, prognosis, therapy, etc.) and "Publication Type" (e.g. randomized controlled trial, systematic review, etc.). The "+" represents additional query parameters such as patient signalment (e.g. species, breed, sex) and a filter to restrict results to full-text articles from open access journals. Another approach to PICO is the educational prescription (PDF)
Asking a focused and answerable question is an important initial step in the development of a Clinical Knowledge Summary (CKS) such as a Critically Appraised Topic (CAT), a BestBET (Best Evidence Topic) or a POEM (Patient-Oriented Evidence That Matters). See the excellent "How to Write a Critically Appraised Topic (CAT)" (574KB PDF) by Sadigh G. et al., McMaster University, 2012.
The PICO methodology has been around for some time. While it's an important evidence-based medicine paradigm, putting PICO into action, especially at the point-of-care, is challenging. Answering clinical questions requires an array of knowledge acquisition skills such as building relatively complex queries within a biomedical literature resource such as PubMed or CABI's VetMed Resource, an understanding of the limitations of various publication types (from case reports to systematic reviews), effective critical appraisal of the literature and of course the time required to plan and execute such a query.
PICO tutorials or text-based "toolkits" are good introductions, but it's uncertain how well they transform clinician behavior towards using PICO-based questions to perform literature searches when they arise directly during patient care. The National Library of Medicine has developed a PICO for handhelds site, but it does not specialize the search sufficiently for veterinary medicine. A PICO query tool ostensibly reduces some of the adoption barriers by making it easier to perform a search at the point-of-care — whether from a mobile, laptop or desktop device.
The author considers this only an intermediate solution. It would be desirable to build queries directly from semantically rich patient information within the electronic health record as anticipatory background tasks, using the Context-Aware Knowledge Retrieval (Infobutton) standard.
See the companion help page to learn more about the structure of a PICO query and guidance on each section of the query form.
This is a developmental βeta release to evaluate user experience and interface design, form content and logic, query rules or parameters (e.g. controlled vocabulary terms and conditional operators), technical requirements and bugs before testing with a wider audience. Integration with other resources, such as CABI's VetMed Resource and Google Scholar is in development.
The responsive UI should work with any device — from smartphone, tablet to desktop browsers. We'll prioritize work on overall functionality before making more detailed refinements to the design.
The following are some existing design features. These are expected to change - perhaps substantially. Unless stated otherwise, all comments relate to PubMed queries.
(veterinary[sb] OR "veterinary"[Subheading] OR "veterinary"[All Fields])
"Dogs"[MeSH] AND "Cats"[MeSH]
(sensitiv*[Title/Abstract] OR sensitivity and specificity[MeSH Terms] OR diagnose[Title/Abstract] OR diagnosed[Title/Abstract] OR diagnoses[Title/Abstract] OR diagnosing[Title/Abstract] OR diagnosis[Title/Abstract] OR diagnostic[Title/Abstract] OR diagnosis[MeSH:noexp] OR diagnostic * [MeSH:noexp] OR diagnosis,differential[MeSH:noexp] OR diagnosis[Subheading:noexp])
("veterinary"[Subheading] OR "veterinary"[All Fields]) AND "Dogs"[Mesh] AND osteoarthritis AND nsaid AND surgery AND (randomized controlled trial[Publication Type] OR (randomized[Title/Abstract] AND controlled[Title/Abstract] AND trial[Title/Abstract])) AND "Clinical Trial" [Publication Type] AND "last 3 years"[PDat]
pmc cc license[filter]