Evidence-Based Practice: ASK - PICO
This guide is designed to assist health care professionals to become effective and efficient users of the medical and nursing literature.
Evidence-Based Practice: Navigation
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* The Underappreciated and Misunderstood PICOT Question: A Critical Step in the EBP Process. [Article]
* How to Create a Well-Built Clinical Question - from NLM
* PICO and Search Query Worksheet [pdf] from Ebling Library - University of Wisconsin-Madison
Background vs. Foreground Questions
When to use PICO ...
Background questions concern general knowledge. These types of questions generally have only 2 parts:
1) A question root (who, what, when, where, how, why) and
2) a disorder, test, treatment, or other aspect of health care.
Often these questions can best be answered by using a textbook or consulting a clinical database.
Example Background Question: What are the best interventions to prevent accidental falls in the elderly?
Foreground questions are specific knowledge questions that affect clinical decisions, including a broad range of biologic, psychological, and sociologic issues. These are the questions that generally require a search of the primary medical literature and that are best suited to the PICO format.
What is the P.I.C.O. Model?
Defining a clinical question in terms of the specific patient problem aids the searcher in finding clinically relevant evidence in the literature.
Essentially, PICO is a focused search strategy.
P-I-C-O Model for Clinical Questions
|P||Patient, Population, or Problem||How would I describe a group of patients similar to mine?|
|I||Intervention, Prognostic Factor, or Exposure|| Which main intervention, prognostic factor,
or exposure am I considering?
|C||Comparison or Intervention (if appropriate)|| What is the main alternative to compare
with the intervention?
|O||Outcome you would like to measure or achieve|| What can I hope to accomplish, measure,
improve, or affect?
|T||Time Interval||What is the time interval to achieve desired outcomes?|
|What type of question are you asking?|| Diagnosis, Etiology/Harm, Therapy, Prognosis,
|Type of study you want to find||What would be the best study design/methodology?|
Example PICO Questions
Therapy / Intervention Example : In the elderly (P), does aspirin (I) reduce the risk of heart attacks (O)?
Intervention Example : In hospitalized adults (P), how does a Rapid Response Team (I) affect the number of cardiac arrests (O) and unplanned admissions to the ICU (O) during a 3-month period?
Diagnosis Example : In healthcare settings, does screening for intimate partner/domestic violence (I) improve quality-of-life (O) for women (P)?
Meaning Example : How do family caregivers (P) with relatives receiving hospice care (I) receive the loss of their loved one (O) during end-of-life (T)?
Comparative Intervention / Therapy Example : In patients with dementia who are agitated (P), how does baby doll therapy (I) compared with Risperdone drug therapy (C) affect behavior outbursts (O) within 1 month (T)?