- POEM (continued)
As clinicians, our most fundamental questions center on diagnosis, prognosis, or therapy in individual
patients. The acronym POEM (Patient Oriented Evidence that Matters) suggests that questions are most
relevant when they relate to specific patients or clearly identified groups of patients.
- PICO
To build your final question (the question that you will try to answer), focus on the following steps:
- Describe your own patient in as much relevant detail as you can:
In a 54 year old white male
with new onset of paroxysmal atrial fibrillation and a large left atrium
- Describe what you want to answer or ask about your specific patient:
would anticoagulation with warfarin
- Describe the comparison or the alternative:
as opposed to no therapy at all
- Describe your goal or desired outcome:
reduce the risk of embolic stroke or reduce mortality?
This is called a PICO question: Patient Intervention
Control Outcome.
When you have addressed these issues, write out the question. Writing will force you to be more explicit.
Pay special attention to the outcome. Lowering cholesterol is not the same as preventing heart attacks.
Pick an outcome that is relevant to your patient.
