從實證醫學的 PICO 向 AI 提問

PICO 是實證醫學 (Evidence-Based Medicine, EBM) 中一種實用的簡潔問題架構。

PICO 代表 Population, Intervention, Comparison, and Outcome。

透過把臨床問題寫成 PICO 的形式，可以更清楚所要探討的問題重點，以方便文獻搜尋和討論問題。

建議向 AI 提問的提問詞範例

例 1. 整理實證摘要

I am a medical doctor dedicated to evidence-based medicine.
PICO stands for Population, Intervention, Comparison, and Outcome.
Provide an evidence-based summary answering the problem in the context.
[context]
Problem: In patients with suspected deep vein thrombosis, is D-dimer testing more accurate than ultrasound in diagnosing the condition?
Type: diagnosis
P: patients with suspected deep vein thrombosis
I: D-dimer testing
C: ultrasound
O: accuracy of diagnosis of deep vein thrombosis

例 2. 搜尋近期文獻

I am a medical doctor dedicated to evidence-based medicine.
PICO stands for Population, Intervention, Comparison, and Outcome.
Search for the latest evidence on the problem in the context.
[context]
Problem: In patients with suspected deep vein thrombosis, is D-dimer testing more accurate than ultrasound in diagnosing the condition?
Type: diagnosis
P: patients with suspected deep vein thrombosis
I: D-dimer testing
C: ultrasound
O: accuracy of diagnosis of deep vein thrombosis

臨床問題 和 PICO 的類型

PICO 的架構根據臨床問題可以分成以下 5 類：

1. Diagnosis:

• Example: In patients with suspected deep vein thrombosis (P), is D-dimer testing (I) more accurate than ultrasound (C) in diagnosing the condition (O)?

• Population: Patients with a specific condition or set of symptoms.

• Intervention: A diagnostic test or procedure.

• Comparison: Another diagnostic test or procedure.

• Outcome: Accuracy, sensitivity, specificity, predictive values, etc.

2. Therapy:

• Example: In adults with hypertension (P), does treatment with ACE inhibitors (I) reduce the risk of stroke (O) compared with beta-blockers (C)?

• Population: Patients with a specific condition.

• Intervention: A treatment or intervention.

• Comparison: A placebo, standard care, or another treatment.

• Outcome: Efficacy, side effects, mortality, quality of life, etc.

3. Prognosis:

• Example: In patients with early-stage breast cancer (P), how does tumor size (I) influence 5-year survival rates (O) compared to patients with larger tumors (C)?

• Population: Patients with a specific condition or risk factor.

• Intervention: The prognostic factor or condition.

• Comparison: The absence of the prognostic factor or condition.

• Outcome: Outcomes such as disease progression, survival rates, complications, etc.

4. Etiology/Harm:

• Example: In smokers (P), does smoking (I) increase the risk of developing lung cancer (O) compared to non-smokers (C)?

• Population: Patients with a particular exposure or condition.

• Intervention: The exposure or risk factor.

• Comparison: Lack of exposure or a different exposure.

• Outcome: Adverse effects, incidence of disease, etc.

5. Prevention:

• Example: In elderly patients (P), does vaccination with the influenza vaccine (I) reduce the incidence of influenza (O) compared to those who do not receive the vaccine (C)?

• Population: People at risk for a specific condition.

• Intervention: A preventive measure.

• Comparison: No preventive measure or a different measure.

• Outcome: Incidence of the condition, adverse effects, etc.

從已知的 PICO，向 ChatGPT 提問的 10 個問法

如果我們已經有了問題和 PICO，例如：

Problems: In adult patient with hypertension, does amlodipine reduce the risk of myocardial infarction compared with valsartan? 

Type: therapy

P: adult with hypertension

I: treat with amlodipine

C: treat with valsartan

O: reduction of myocardial infarction

可以參考以下 10 種示例來向 ChatGPT 提問：

1. Direct Query for Evidence-Based Summary:
   
   

   • "Provide an evidence-based summary comparing the efficacy of amlodipine versus valsartan in reducing the risk of myocardial infarction in adult patients with hypertension."
     
     

2. Specific Focus on Studies:
   
   

   • "Summarize clinical studies that compare the effectiveness of amlodipine and valsartan in reducing myocardial infarction risk among adults with hypertension."
     
     

3. Meta-Analysis Information:
   
   

   • "Is there a meta-analysis comparing amlodipine and valsartan for myocardial infarction prevention in hypertensive adults? Summarize the findings."
     
     

4. Guideline Recommendations:
   
   

   • "What do current clinical guidelines recommend regarding the use of amlodipine versus valsartan for reducing myocardial infarction risk in hypertensive adults?"
     
     

5. Statistical Outcomes:
   
   

   • "Provide statistical data comparing the reduction of myocardial infarction risk in hypertensive adults treated with amlodipine versus valsartan."
     
     

6. Long-term Effects Comparison:
   
   

   • "Compare the long-term effects of amlodipine and valsartan on myocardial infarction risk in adults with hypertension based on recent evidence."
     
     

7. Side Effects and Benefits:
   
   

   • "What are the side effects and benefits of amlodipine compared to valsartan in terms of reducing myocardial infarction risk in adult hypertensive patients?"
     
     

8. Patient-Centered Outcomes:
   
   

   • "How do patient-centered outcomes compare between amlodipine and valsartan in hypertensive adults concerning myocardial infarction prevention?"
     
     

9. Real-World Evidence:
   
   

   • "Is there real-world evidence supporting the use of amlodipine over valsartan for reducing myocardial infarction risk in adult patients with hypertension?"
     
     

10. Summary of RCTs:
    
    

    • "Summarize randomized controlled trials (RCTs) that compare the effectiveness of amlodipine and valsartan in reducing myocardial infarction in hypertensive adults."