PICO Clinical Questions
PICO is a framework for developing a clinical question that is focused, specific, and answerable. This widely used tool is the first step in evidence-based practice.
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 questions help identify keywords or search terms in order to efficiently search for the best evidence for making patient care decisions.
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. Use to determine which treatment will result in the best outcome.
Template:
In ____(P), how does ____ (I) compared with ____ (C) affect ____ (O)?
In hospitalized adults (P), how does hourly rounding (I), compared with no rounding (C), affect falls (O)?
Diagnosis Questions
To select and interpret diagnostic tests in order to confirm or exclude a diagnosis.
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
Identify 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
To determine 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
Some study designs are better suited to answer each type of clinical question. Use the evidence pyramid to help you determine the best type of evidence to answer your question.
Questions & Help
If you have questions on this, or another topic, contact a librarian for help!