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PICO Clinical Questions

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PICO is a framework for developing a clinical question that is focused, specific, and answerable. PICO is a widely used tool, and the first step in evidence-based practice. Formulating a PICO question helps to identify keywords or search terms for efficiently searching the literature for the best evidence for making patient care decisions.

What is PICO?

PICO is a mnemonic used to describe the elements of a clinical question:

P Population or Patient Problem
What is the problem to be addressed?
I Intervention
What action, change, or treatment would affect the population or patient problem?
C Comparison
What is the alternative to the intervention?
O Outcome
What are you trying to accomplish, measure, improve or affect?
OPTIONAL
T Timeframe

PICO Templates

The PICO elements can be structured into different types of research questions. You may not need to include all components of PICO; often two or three elements are sufficient.

Therapy Questions

The most commonly-used format. Determines which treatment will result in the best outcome.

In ____(P), how does ____ (I) compared with ____ (C) affect ____ (O)?

Example:
In hospitalized adults (P), how does hourly rounding (I), compared with no rounding (C), affect falls (O)?

Diagnosis Questions

Determines the ability of a test to predict the likelihood of a disease.

Template: In ___ (P), is ___ (I) compared with ___ (C) more accurate in diagnosing ___ (O)?

Example:
In children (P), is abdominal ultrasound (I), compared with CT scan (C) more accurate in diagnosing accute appendicitis (O)?

Etiology Questions

Identifies negative impacts from an intervention, greatest risk factors, or causes of a condition.

Template: Are ___(P) who have ___(I) compared with ___(C) at ___ risk for ___(O)?

Example:
Are older adults (P) who have chronic sleep deprivation (I), compared with those who get adequate sleep (C), at increased risk for developing cognative impairment (O)?

Prognosis Questions

Determines the progression of a disease or likelihood of a disease occuring.

Template: In ___(P), how does ___(I) compared with ___(C) influence ___(O)?

Example:
In young adults with major depressive disorder (P), how does cognative behavioral therapy (I), compared with no therapy (C), influence long-term relapse rates(O)?

Study Types

Different types of study designs are used to answer different types of questions. Use the evidence pyramid to help you determine the best study types and levels of evidence to answer your question.

Questions & Help

If you have questions on this, or another topic, contact a librarian for help!