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.
Question & Study Types
The PICO format can be adapted to address different types of research questions. Find the PICO format and best study types below to answer your research question.
Therapy Questions
Determines which treatment will result in the best outcome. This is the most common and flexible question type.
Template:Â In ___(P) how does ___ (I) compared with ___(C) affect ___(O) within ___(T)?
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. Â You may not always find the highest level of evidence; when this happens, look for:
Diagnosis Questions
Determines the ability of a test to predict the likelihood of a disease.
Template:Â In ___ (P) is ___ (I) compared with ___ (C) more accurate in diagnosing ___ (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. Â You may not always find the highest level of evidence; when this happens, look for:
Etiology Questions
Identifies negative impacts from an intervention, greatest risk factors, or causes of a condition.
Template:Â Are ___(P) who have ___(I) compared with ___(C) at ___ risk for ___(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. Â You may not always find the highest level of evidence; when this happens, look for:
Prognosis Questions
Determines the progression of a disease or likelihood of a disease occuring.
Template:Â In ___(P) how does ___(I) compared with ___(C) influence ___(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. Â You may not always find the highest level of evidence; when this happens, look for:
Questions & Help
If you have questions on this, or another, topic, contact a librarian for help!