Health Sciences

Clinical and nursing practice questions can be broken down into to make the information-seeking process easier.

Write a PICO question when you are asking foreground questions, not background questions. 

• Background questions are usually informational questions about a topic and do not require the PICO framework to answer.
• Foreground questions look for answers to specific patients, problems, types of interventions, and clinical outcomes, and the PICO framework will work well with these questions.

Use PICO to write a clear, researchable clinical question. The four elements of PICO break a research topic into searchable keywords and make locating evidence-based practice research sources easier. 

PICO is an acronym for: 

• P: Patient, population, or problem
• I: Intervention, prognostic factor or exposure 
• C: Comparison or intervention (if appropriate)
• O: the Outcome to measure or achieve

PICO may sometimes include these additional letters. Use these to make your search even more specific:

• T: Timeframe
• T: Type of Study
• S: Setting

PICO questions are written differently for the below clinical question types. 

Clinical Question Types:

• Therapy/Intervention: Questions that examine the effectiveness of interventions (i.e. treatment) in improving outcomes in patients. This is the most common type of clinical question. 
• Etiology/Harm: Questions that evaluate negative impacts from an intervention or exposure, or research the cause of a problem.
• Diagnosis/Diagnostic Test: Questions that analyze the use of a test to identify a disorder or predict a disease.
• Prevention: Questions that examine the use of medication or other intervention in the prevention of a disease or condition.
• Prognosis/Predictions: Questions that examine the progression of a disease or likelihood of a disease occurring.
• Meanings: Questions that examine a patient's perceptions.

PICO (Problem/Population, Intervention, Comparison, Outcome)

Appropriate for: clinical questions, often addressing the effect of an intervention/therapy/treatment

Example: For Millennials with type II diabetes (P) does the use of telehealth consultations (I) compared to in-person consultations (C) promote weight loss (O)?

When reading an article, report, or other summary of a research study, there are two principal questions to keep in mind:

1.  Is this relevant to my patient or the problem? 

2.  Is the evidence in this study valid?

                                                    The pyramid below represents the hierarchy of evidence