PICO Clinical Questions
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:
- Population or Patient Problem
- What is the problem to be addressed?
- Intervention
- What action, change, or treatment would affect the population or patient problem?
- Comparison
- What is the alternative to the intervention?
- Outcome
- What are you trying to accomplish, measure, improve or affect?
- OPTIONAL
- Timeframe
PICO Template
The PICO elements can be structured into a question that you can then address with relevant quality evidence. The basic format for a PICO question is:
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)?
You may not need to include all components of PICO; often two or three elements are sufficient. The question format is slightly different for different types of research questions.
Question & Study Types
The following table provides PICO templates for each type of question along with recommended study types as shown in the evidence pyramid.
| Question Type | Determines | PICO Template | Study Types* |
|---|---|---|---|
| Therapy | Which treatment will result in the best outcome | In______(P) how does___(I) compared with___(C) affect___(O) within___(T) |
randomized controlled trial (RCT) cohort study case control case series |
| Diagnosis | Ability of a test to predict likelihood of a disease | In _________(P) is ___________(I) compared with___(C) more accurate in diagnosing___(O) |
randomized controlled trial (RCT) cohort study case control |
| Etiology | Negative impacts from an intervention, greatest risk factors or causes of a condition | Are _______(P) who have ___(I) compared with____(C) at_____risk for ___(O) |
randomized controlled trial (RCT) cohort study case control case series |
| Prognosis | Progression of a disease or likelihood of a disease occurring | In _________ (P) how does _______(I) compared with___(C) influence____(O) |
cohort study case control case series |
Questions & Help
If you have questions on this, or another, topic, contact a librarian for help!