PICOT Questions

What is a PICOT Question?

The PICOT question format is a consistent “formula” for developing answerable, researchable questions. When you write a good one, it makes the rest of the process of finding and evaluating evidence much more straightforward.

• P: Population/patient – age, gender, ethnicity, individuals with a certain disorder
• I: Intervention/indicator (Variable of Interest) – exposure to a disease, risk behavior, prognostic factor
• C: Comparison/control – 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 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.

Developing Clinical Question

PICOT Questions Template

Template for Asking  PICOT Questions

INTERVENTION In  ____________________(P),  how  does  ____________________  (I)  compared  to ____________________(C)  affect  _____________________(O)  within  ___________(T)?

THERAPY In  __________________(P),  what  is  the  effect  of  __________________(I)  compared  to _____________  (C)  on  ________________(O within  _____________(T)?

PROGNOSIS/PREDICTION In  ______________  (P),  how  does  ___________________  (I)  compared  to  _____________(C) influence  __________________  (O)  over  _______________  (T)?

DIAGNOSIS  OR  DIAGNOSTIC  TEST In  ___________________(P)  are/is  ____________________(I)compared with _______________________(C)  more  accurate  in  diagnosing  _________________(O)?

ETIOLOGY Are____________________  (P),  who  have  ____________________  (I)  compared  with  those without  ____________________(C)  at  ____________  risk  for/of ____________________(O)  over  ________________(T)?

MEANING How  do  _______________________  (P)  with  _______________________  (I)    perceive _______________________(O)  during  ________________(T)?

Adapted from the PICOT Questions Template; Ellen Fineout-Overholt, 2006. This form may be used for educational & research purposes without permission.

Short Definitions of Different Types of Questions

Intervention/Therapy: Questions  addressing  the  treatment  of  an  illness  or  disability.
Etiology:  Questions  addressing the  causes  or  origins of  disease (i.e.,  factors  that produce  or  
predispose  toward  a  certain  disease  or  disorder).
Diagnosis:  Questions  addressing  the  act  or  process  of  identifying  or  determining  the  nature  and  
cause  of  a  disease  or  injury  through  evaluation.
Prognosis/Prediction:  Questions  addressing  the  prediction  of  the  course  of  a  disease.
Meaning: Questions  addressing  how  one  experiences  a  phenomenon.

Sample PICOT Questions Questions:

Intervention:  In  African-­‐American  female  adolescents  with  hepatitis  B  (P),  how  does  
acetaminophen  (I)  compared  to  ibuprofen  (C)  affect  liver  function  (O)?
Therapy: In  children  with  spastic  cerebral  palsy  (P),  what  is  the  effect  of  splinting  and  casting(I)  
compared  to  constraint-­‐ induced  therapy  (C)  on  two-­‐handed  skill  development  (O)?
Prognosis/Prediction:  
1)  For  patients  65  years  and  older  (P),  how  does  the  use  of  an  influenza  vaccine  (I)  compared  to  
not  received  the  vaccine  (C)  influence  the  risk  of  developing  pneumonia  (O)  during  flu  season  
(T)?  
2)  In  patients  who  have  experienced  an  acute  myocardial  infarction  (P),  how  does  being  a  
smoker  (I)  compared  to  a  non-­‐smoker  (C)  influence  death  and  infarction  rates  (O)  during  the  
first  5  years  after  the  myocardial  infarction  (T)?
Diagnosis: In  middle-­‐aged  males  with  suspected  myocardial  infarction  (P),  are  serial  12-­‐lead  
ECGs  (I)  compared  to  one  initial  12-­‐lead  ECG  (C)  more  accurate  in  diagnosing  an  acute  
myocardial  infarction  (O)?
Etiology: Are  30-­‐ to  50-­‐year-­‐old  women  (P)  who  have  high  blood  pressure  (I)  compared  with  
those  without  high  blood  pressure  (C)  at  increased  risk  for  an  acute  myocardial  infarction  (O)  
during  the  first  year  after  hysterectomy  (T)?
Meaning: How  do  young males  (P)  with  a  diagnosis  of  below  the  waist  paralysis  (I)  perceive  
their  interactions  with  their  romantic  significant  others (O)  during  the  first  year  after  their  
diagnosis  (T)?

PICOT question ideas and examples

Picot Question Ideas

A PICOT question format idea should be a consistent formula to develop researchable and answerable questions. The process of finding and evaluating evidence will be more straightforward when you create a good PICOT question. PICOT questions should bring multiple concepts that relate to a research topic or a specific clinical situation together. For simple formulation you can have a PICOT question in these two categories:

ALSO READ: BEST NURSING PICO-PROJECT WRITING SERVICES ONLINE

Qualitative questions:Aim at gaining an understanding or discover the meaning of phenomena.These questions ask about the experience of a person or population regarding certain circumstances or situations.

Quantitative questions:these are questions that compare two or more individuals sometimes groups based on different outcomes with an aim at discovering the cause and effect relationships. The results of quantitative questions are associated with interventions or exposures.Forming a question using the PICO framework requires deeper thinking about the type of question to ask. It should either focus on therapy, diagnosis, prognosis, etiology or prevention to give the question a particular domain.

PICO Question Examples

It will be a time-consuming and difficult venture to identify the most appropriate resources and find relevant evidence without a well-focused question. PICO helps to form a question and facilitate quick and wider literature search.PICO framework helps to identify the main elements of a question and simplify writing a question statement. These are some examples of PICO questions that fit to the framework.

Example 1:

Does hand washing by healthcare providers reduce transmission of hospital-acquired infections? The question first into PICO elements

P-Hospital-acquired infection

I-Hand washing

C-Alternative to hand washing such as wearing a mask or gloves

O-reducing infection

Example 2:

Do turning bedridden patients reduce the risk of pressure ulcers than pressure mattresses?

P-Pressure ulcers in bedridden patients

I-Turning a patient

C-Pressure mattress

O-Prevent pressure ulcers

Example 3:

How do pregnant women diagnosed with obesity prefer dietary changes or workout to reduce weight during pregnancy and six weeks postpartum?

P-women diagnosed with diabetes

I-Dietary changes

C-Workout

O-Weight loss

T-Six weeks

Conclusion

PICO (T) questions should have four concepts or components that help in making a clinical decision. A PICOT question should compare interventions or actions by healthcare professionals as they care for patients. The purpose is to identify and decide on the most beneficial intervention. Most of the PICO questions address diagnosis and interventions.