Skip to main content

Evidence Based Nursing

What is PICO

PICO is a way to help structure a research question and then take that question and translate it into search phrases.

The research question is looking to find clinical information related to a specific patient, intervention or therapy.

Here is an article that helps to explain a bit more about PICOT:

Riva, J. J., Malik, K. M. P., Burnie, S. J., Endicott, A. R., & Busse, J. W. (2012). What is your research question? An introduction to the PICOT format for clinicians. Journal of the Canadian Chiropractic Association56(3), 167–171.

What PICO means

P: Population/disease ( i.e. age, gender, ethnicity, with a certain disorder)

I: Intervention or Variable of Interest (exposure to a disease, risk behavior, prognostic factor)

C: Comparison: (could be a placebo or "business as usual" as in no disease, absence of risk factor, Prognostic factor B )

O: Outcome: (risk of disease, accuracy of a diagnosis, rate of occurrence of adverse outcome)

T: Time: The time it takes to demonstrate an outcome (e.g. the time it takes for the intervention to achieve an outcome or how long participants are observed).

Note: Not every question will have an intervention (as in a meaning question) or time (when it is implied in another part of the question) component.

PICO Template Questions

For an intervention/therapy:

In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)?

For etiology:

Are ____ (P) who have _______ (I) at ___ (Increased/decreased) risk for/of_______ (O) compared with ______ (P) with/without ______ (C) over _____ (T)?

Diagnosis or diagnostic test:

Are (is) _________ (I) more accurate in diagnosing ________ (P) compared with ______ (C) for _______ (O)?

Prevention:

For ________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ (C)?

Prognosis/Predictions

Does __________ (I) influence ________ (O) in patients who have _______ (P) over ______ (T)?

Meaning

How do ________ (P) diagnosed with _______ (I) perceive ______ (O) during _____ (T)?

Templates from Sonoma State University.

Sample PICO Questions Using the Templates

Intervention/Therapy:

In school-age children (P), what is the effect of a school-based physical activity program (I) on a reduction in the incidence of childhood obesity (O) compared with no intervention (C) within a 1 year period (T)?

In high school children (P), what is the effect of a nurse-led presentation on bullying (I) on a reduction in reported incidences of bullying (O) compared with no intervention (C) within a 6 month time frame (T)?

Etiology:

Are males 50 years of age and older (P) who have a history of 1 year of smoking or less (I) at an increased risk of developing esophageal cancer (O) compared with males age 50 and older (P) who have no smoking history (C)?

Are women ages 25-40 (P) who take oral contraceptives (I) at greater risk for developing blood clots (O) compared with women ages 25-40 (P) who use IUDs for contraception (C) over a 5 year time frame (T)?

Diagnosis/Diagnostic Test:

Is a yearly mammogram (I) more effective in detecting breast cancer (O) compared with a mammogram every 3 years (C) in women under age 50 (P)?

Is a colonoscopy combined with fecal occult blood testing (I) more accurate in detecting colon cancer (O) compared with a colonoscopy alone (C) in adults over age 50 (P)?

Prevention:

For women under age 60 (P), does the daily use of 81mg low-dose Aspirin (I) reduce the future risk of stroke (O) compared with no usage of low-dose Aspirin (C)?

For adults over age 65 (P) does a daily 30 minute exercise regimen (I) reduce the future risk of heart attack (O) compared with no exercise regimen (C)?

Prognosis/Predictions:

Does daily home blood pressure monitoring (I) influence compliance with medication regimens for hypertension (O) in adults over age 60 who have hypertension (P) during the first year after being diagnosed with the condition (T)?

Does monitoring blood glucose 4 times a day (I) improve blood glucose control (O) in people with Type 1 diabetes (P) during the first six months after being diagnosed with the condition (T)?

Meaning:

How do teenagers (P) diagnosed with cancer (I) perceive chemotherapy and radiation treatments (O) during the first 6 months after diagnosis (T)?

How do first-time mothers (P) of premature babies in the NICU (I) perceive bonding with their infant (O) during the first month after birth (T)?