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RN-BSN Library Guide

Use this Library Research Guide to help locate evidence-based resources including articles, information on research appraisal, statistics, evidence translation, clinical practice tools, informatics and professional resources.

PICO Acronym

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

 

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?

T = Time (if applicable) - The time frame of treatment and/or measurable outcome.

PICO(T) and Its History

PICO is an acronym used to remember the key components of a clinical question. Physicians first developed the PICO framework in evidence-based medicine as a way to address knowledge gaps during patient encounters. Questions could arise around a patient’s diagnosis, prognosis, and therapy, as well as around prevention strategies and patient education. Since then, PICO has become the most widely used question framework for evidence-based practice.

The Purpose of PICO(T)

PICO(T) is useful in academic and clinical settings. It can help you:

  • form a question that focuses on the most important issue for a patient or a population
  • identify key terms to use in a search for evidence
  • select results that directly relate to the situation

PICO(T) has some limitations. The framework privileges interventions, experimental research, and dominant voices.

McKenzie JE, Brennan SE, Ryan RE, Thomson HJ, Johnston RV, Thomas J. Chapter 3: Defining the criteria for including studies and how they will be grouped for the synthesis. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.2 (updated February 2021). Cochrane, 2021. Available from www.training.cochrane.org/handbook This link opens in a new window

Fill in the blanks with information from your clinical scenario:

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

ETIOLOGY
Are ______________ who have _______________ at ______________ risk for/of ____________ compared with _____________ with/without ______________?

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

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

PROGNOSIS
Does ____________ influence ______________ in patients who have _____________? 

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.

Below are some sample questions using the PICO method of inquiry.

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.