Research Guides: NRS Year 1 and Year 2 Research Support: PICO(T)

PICO(T) clinical questions

PICO(T) is a mnemonic tool used in evidence-based practice (EBP) to help you clarify your clinical question. PICO(T) acts as a framework, asking you to think specifically about different aspects of what you want to investigate. It also helps formulate your search strategy (keywords, type of study) by identifying the key concepts that should show up if a research article is to be relevant for answering your question.

P: Patient, Problem, or Population
What are the most important characteristics of the patient? How would you describe a group of patients similar to yours? (disease or health status, age, race, sex)

I: Intervention
What main intervention, exposure, or prognostic factor are you considering? What do you plan to do for the patient? (specific tests, therapies, medications)

C: Comparison
What is the alternative to your plan? (no treatment, different type of treatment)

O: Outcome
What are you trying to accomplish, measure, improve or affect? What are examples of those outcomes? (fewer symptoms, no symptoms, full health, etc.)

T: Time (optional)
What is the time frame for demonstrating a clinical outcome?

Developing a PICO(T) question

Information regarding developing a PICO question can be found on Evolve.

The type of clinical research question you ask differs depending on the patient need or problem at hand. The way you frame your research question helps facilitate your search for an answer.

Intervention / Therapy

Questions addressing how a clinical issue, illness, or disability is treated.
In _______ (P), what is the effect of _______ (I) on _______ (O) compared with _______ (C) within _______ (T)?

Etiology

Questions that address the causes or origin of disease, the factors which produce or predispose toward a certain disease or disorder.
Are _______ (P) who have _______ (I) at [increased / decreased] risk for / of _______ (O) compared with _______ (P) with / without _______ (C) over _______ (T)?

Diagnosis or diagnostic test

Questions addressing the act or process of identifying or determining the nature and cause of a disease or injury through evaluation.
Are (is) _______ (I) more accurate in diagnosing _______ (P) compared with _______ (C) for _______ (O)?

Prevention

Questions addressing the prevention of a problem.
For _______ (P) does the use of _______ (I) reduce the future risk of _______ (O) compared with _______ (C)?

Prognosis / Predictions

Questions addressing the prediction of the course of a disease.
In _______ (P) how does _______ (I) compared to _______ (C) influence _______ (O) over _______ (T)?

Meaning

Questions addressing how one experiences a phenomenon or why we need to approach practice differently.
How do _______ (P) diagnosed with _______ (I) perceive _______ (O) during _______ (T)?

Additional resources

Formulating answerable questions
Part of the "Evidence-Based Medicine Toolbox," created by KT Canada.
PICOT question template
Created by AAACN; use this guide to help structure your PICOT question.

PICO(T) is the most widely-used clinical question framework for evidence-based practice; it also is not without limitations.

PICO privileges interventions. PICO primarily centers on intervention (or therapy) clinical questions. It can be less suitable for other question types.
PICO privileges experimental research. PICO privileges research that is experimental or observational in nature. It does not account for complexities like considering feasibility, context, and sociocultural acceptability.
PICO privileges dominant voices. Evidence-based practice (EBP) defines evidence according to a pyramid with randomized controlled trials recognized as the highest level of primary evidence. This hierarchy of evidence can exclude the voices of minority populations and the interests of those in non-dominant populations. Thus, EBP, while seemingly objective, often reflects White voices and assumptions of the majority. Therefore, the use of PICO to frame literature searches may prove successful for questions with dominant populations and result in evidence gaps for non-dominant populations.

Visit https://guides.lib.unc.edu/pico/limitations for suggested ways to address limitations.