VCU Libraries

Research Guides

Evidence-Based Medicine

Steps in EBM Process

  • Assess the patient
  • Ask the question
  • Acquire the evidence
  • Appraise the evidence
  • Apply to the patient
  • Evaluate

P.I.C.O. Model

Before searching for EBM materials it is helpful to frame your question using the P.I.C.O. method. 

  • Patient, Population, or Problem
  • Intervention, Prognostic factor, or Exposure
  • Comparison or Intervention (if appropriate)
  • Outcome

You should also ask what type of question are you asking - diagnosis, etiology, therapy, prevention, or harm?

The Evidence Pyramid

The pyramid below illustrates the spectrum of materials one can find.  At the bottom of the pyramid are the materials that are the least clinically relevant. At the top are the most clinically relevant. 



Source: Source: SUNY Downstate Medical Center. Medical Research Library of Brooklyn. Evidence Based Medicine Course. A Guide to Research Methods: The Evidence Pyramid.