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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.

PICO Tools


     *  PICO and Search Query Worksheet [pdf]  from Ebling Library - University of Wisconsin-Madison

     *  PICO Linguist / Babel MeSH - Multilanguage search for Medline/PubMed from The National Library of Medicine

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.

PICO Search


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)?