Bristol Community College Library Learning Commons: Evidence-Based Practice: PICO

Asking a Clinical Question

Using the PICO format can be instructive!

Patient Population
Intervention
Comparison Intervention
Outcome

Types of Questions: Etiology, Diagnostic, Prevention, Prognosis/Prediction, Therapy, Qualitative

Prevention Example:
For patients with systolic heart failure (P) do exercise programs (I) reduce the future risk of hospital admission due to heart failure (O) compared with patients without exercise programs (C)?
Therapy Example:
In patients with chronic wounds (P) what is the effect oftopical negative pressure (TNP) (I) on promoting healing (O) compared with traditional moisturized gauze (C) dressing?

Element of the clinical question	Patient Describe as accurately as possible the patient or group of patients of interest.	Intervention (or cause, prognosis) What is the main intervention or therapy you wish to consider? Including an exposure to disease, a diagnostic test, a prognostic factor, a treatment, a patient perception, a risk factor, etc.	Comparison (optional) Is there an alternative treatment to compare? Including no disease, placebo, a different prognotic factor, absence of risk factor, etc.	Outcome What is the clincial outcome, including a time horizon if relevant?
Example	In patients with acute bronchitis,	do antibiotics	none	reduce sputum production, cough or days off?
Example	In children with cancer	what are the current treatments		in the management of fever and infection?
Example	Among family-members of patients undergoing diagnostic procedures	does standard care,	listening to tranquil music, or audiotaped comedy routines	make a difference in the reduction of reported anxiety.

PICO chart