Evidence Based Practice Guide for Nursing Students: PICO

The PICO question is a different way to think about the clinical questions that arise during patient care. Unlike informational questions, these questions are quite complex and sometimes a challenge to formulate. They are comprised of specific types of components, or concepts, and have a purpose throughout the EBP process.

The PICO Formula

It is not coincidence that this process is called formulating. When you formulate a PICO question, you are creating a formula that does several things:

• Focus the question by identifying the components or concepts in the question
• Defines the concepts that will be used when performing a complex literature search
• Used to ascertain which articles in a search retrieval best address the question
• Helps determine if studies found address the components of the original question
• Ultimately the process will provide the information needed to make a decision whether the intervention in the PICO question should be implemented

PICO is an acronym that can help you develop and direct your clinical question and research.

PICO stands for:

Population/patient/problem: who is at the heart of your question?

Intervention: what is being done?

Control/comparison: what is not being done or what treatment is this control group not receiving? (May not always be present in your question)

Outcome: what is the goal of your research question?

Sometimes PICO also involves Time becoming PICOT

Time: is there a specific time period of treatment you are studying?

Your PICO question may also address:

Diagnosis: How to select and interpret diagnostic tests

Therapy: How to select treatments to offer patients that do more good than harm and that are worth the efforts and costs of using them

Prognosis: How to estimate the patient’s likely clinical course over time and anticipate likely complications of disease

Etiology: How to identify causes for disease, including genetics

Click this button to go to PICO Questions: A Tutorial

Clinical question:

In a 55 year old man, would the administration of bupropion therapy versus nicotine replacement therapy lead to long-term abstinence from smoking?

PICO:

Patient/problem/population: mid-50s male with a 30 pack-year history of smoking
Intervention: bupropion
Comparison intervention: nicotine replacement therapy
Outcome: long-term abstinence from smoking

Potential Keywords:

• bupropion
• nicotine
• "smoking cessation" OR "tobacco use cessation" OR "tobacco use disorder"
• men OR man OR male

Example adapted from:

Evidence-Based Practice by Various Authors - See Each Chapter Attribution is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.