PICO is a mnemonic used to help you clarify your clinical question.  It acts as a framework, asking you to think specifically about different aspects of what you want to investigate.  As you build your PICO, you should make sure that you are clear and specific about what you are looking for. This helps you target the right evidence to use in practice.  

In some questions, a T is added to the PICO framwork as well to help find a specific level of evidence.

P: Patient, Problem, or Population

I: Intervention

C: Comparison

O: Outcome

T: Timeframe, Type of Study, or Type of Question

Be sure to make your question specific.  What type of patient are you looking for?  Are you using a specific test as your intervention, or a broad group?  If you are looking for better outcomes, what are examples of those outcomes?

A good clinical question will address most, if not all, parts of the PICO framework.  A good PICO will be specific and define terms and outcomes if necessary.  A good PICO will investigate something new in terms of diagnosis, etiology, therapy, harm, etc.

A bad PICO is usually a background question disguised as a research question.  For example, "what are the effects of Prilosec on patients taking immune suppressants" might seem like a good research question, but it is not.  First, effects of a drug are often considered background information because you can look up this information in a drug monograph- you don't need an article to tell you this.  Second, the question is very vague.  What immune suppressant are you looking at?  What are the characteristics of your population?  You need more details to make this a question worth researching.

It may seem tempting to pick a very specific PICO question, but remember, for many nursing school assignments, you need to find existing literature.  If you can't locate articles about your PICO topic, try searching for one or two components first instead of all of them at once. Some articles many cover one part of your PICO and other articles may cover other parts of it.  You need to build your case and explain the research that is out there, so it is alright if your articles don't 100% match your entire PICO question.

Try words from your topic in these templates.  Your PICO should fit only one type of question in the list.

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

In__________ (P) how does ________ (I) compared to _______(C) influence _______ (O) over ______ (T)?

Meaning

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

Templates from Sonoma State University.

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)?

Guide developed with assistance from S. Pruitt, student, SIUE School of Nursing, and 2014 URCA program assistant.