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EBP - Evidence Based Practice for Graduate Students: Research Question - PICO(T)

This guide provides an overview about evidence-based practice and includes links to databases and websites.

Using PICO

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

P =
Patient, Population, Problem		 What is the problem/condition of interest? Are there any important patient characteristics that might influence treatment or the disease progression?  This might include: gender, age, race, ethnicity, or coexisting conditions.
I = Intervention  Interventions might be drug/treatment, diagnostic/screening test, procedure or exposure.  
C = Comparison intervention Alternative being considered (e.g. placebo, standard therapy, no treatment, gold standard). Sometimes there is no “Comparison” element to the PICO statement, such as if you are comparing an intervention with “no treatment” or “placebo”.
O = Outcome What is the clearly defined, desired improvement, measurement or accomplishment that results from the selected treatment or intervention? (e.g. reduced mortality/morbidity, outcome expected from therapy)
T =
Time		 Sometimes  this is added to the end of the PICO to represent how long it takes to demonstrate an outcome.

 

Developing a Well-Built Clinical Question

Clinical practice problems surround us. Some typical questions we might ask are:

  • Does this practice work? Is there something more effective?
  • How can we practice more efficiently?

Clearly defining the specific problem will help focus your search to find the best available evidence.

 

 

Background questions

These questions are used to gain a better understanding about the health condition and to identify search terms.. The essential components of background questions are:

1) A question root (who, what, where, when, how, why)

 2) A disorder, test, treatment

Examples:

  • What causes diabetes?
  • When might complications after stroke occur?

Textbooks, monographs, or web resources are good sources of answers to background questions.

Foreground questions

These are designed to ask about specific information for clinical decision-making and thus focus your search. Foreground questions are often asked in a format called PICO::

1) Patient, Population, Problem

2) Intervention

3) Comparison intervention (if relevant)

4) Outcomes.

An example of a PICO question is:

  • In an older patient with X disorder, is giving Y treatment rather than Z treatment more likely to result in a shorter stay in hospital?

Finding relevant journal articles, using article databases such as PubMed or CINAHL will usually answer foreground questions.

Source: Evidence-Based Practice in Rehabilitation, University of Washington Health Sciences Library, 
http://guides.lib.uw.edu/hsl/ebprehab/intro​

PICO Question: An Example

Research Question P =
Patient, Population, Problem		 I = Intervention C = Comparison intervention O = Outcome
Has research proven that hand hygiene among healthcare workers reduces rates of hospital acquired infection?

hospitals

OR

healthcare workers

OR

nurses

OR

intensive care units

hand hygiene

OR

handwashing

OR

hand washing

OR

hand disinfection

hospital acquired infection

OR

cross infection

OR

nosocomial infection

OR

infection control