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

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P = Population/Patient/Problem – How would I describe the problem or a group of patients similar to mine?

I = Intervention – What main intervention, prognostic factor or exposure am I considering?

C = Comparison – Is there an alternative to compare with the intervention?

O = Outcome – What do I hope to accomplish, measure, improve or affect?

PICO Examples

Element of the clinical question Population/Patient/Problem 

Describe as accurately  as possible the patient or  group of patients of interest.

 Intervention (or cause, prognosis)

What is the main intervention or therapy you wish to consider?
Including an exposure to disease, a diagnostic test, a prognostic factor, a treatment, a patient perception, a risk factor, etc.

 Comparison (optional)

Is there an alternative treatment to compare?
Including no disease, placebo, a different prognostic factor, absence of risk factor, etc.

 Outcome

What is the clinical outcome, including a time horizon if relevant?
Example  In patients with acute bronchitis,  do antibiotics  none  reduce sputum production, cough or days off?
Example  In children with cancer  what are the current treatments  in the management of fever and infection?
Example  Among family-members of patients undergoing diagnostic procedures  does standard care,  listening to tranquil music, or audio taped comedy routines  make a difference in the reduction of reported anxiety.

Asking Different Types of Questions

 

 

 Fill in the blanks with information from your clinical scenario:

THERAPY
In_______________, what is the effect of ________________on _______________ compared with _________________?

PREVENTION
For ___________ does the use of _________________ reduce the future risk of ____________ compared with ______________?

DIAGNOSIS OR DIAGNOSTIC TEST
Are (Is) ________________ more accurate in diagnosing _______________ compared with ____________?

PROGNOSIS
Does ____________ influence ______________ in patients who have _____________?

ETIOLOGY
Are ______________ who have _______________ at ______________ risk for/of ____________ compared with _____________

with/without______________?

MEANING
How do _______________ diagnosed with _______________ perceive __________________?

Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Published by Henry