LibGuides: PICO: Home

What is PICO?

PICO is an acronym for the important parts of a well-designed clinical question. It will help you formulate your search strategy by identifying the key concepts that can be used as search terms.

P	Patient/Population/Problem	What are the relevant characteristics?	age, gender, ethnicity, condition, disease	Always include
I	Intervention	What do you want to do?	medication, surgery, observation, lifestyle change	Always include
C	Comparison/Control	What are the alternative interventions?	placebo, different treatment	Not always present
O	Outcome	What are the possible outcomes/what do you hope to accomplish?	alleviate symptoms, improve functioning, prevent disease, reduce mortality rate	Sometimes include if measurable evidence from rigorous studies exists

PICO variations

PICOT, PICOTT, or PICOS

PICO	Type of question	Time period	Study design or Type of study design
	Therapy/Treatment, Diagnosis, Prognosis, Harm/Etiology (may be referred to as "domains" in PubMed)	Is there a time frame? How long? How long will it take for the intervention to achieve an outcome? How long will participants be observed?	What study design would best answer this question? RCT, Cohort, Case Series, etc.

When to use PICO

Use PICO:

to form a focused question that will return relevant results
to retrieve a manageable number of results
to assist in brainstorming keywords for your research
for questions about patient care
when you are looking for evidence to support best practice
to define clear, focused clinical questions and develope a review protocol

PICO examples

The PICO method is a useful framework to get at the root of a clinical problem, but is not a good format to search a database. You will need to turn your PICO terms into a a search string.

Example: Does hand washing among healthcare workers reduce hospital acquired infections?

Once you have clearly identified the main elements of your question using the PICO framework, it is easy to write your search statement.

Your initial search string might be: "cross infection" AND (Hand washing OR Hand sanitizer)

PICO examples for different question types:

Question Type	Patient/Problem/Population	Intervention	Comparison/Control	Outcome measure
Therapy	In elderly patients with congestive heart failure	is digoxin	compared to a placebo	effective in reducing the need for re-hospitalization?
Prevention	For obese children	does the use of community recreation activities	compared to lessons on lifestyle changes	reduce the risk of developing type 2 diabetes?
Diagnosis	For deep vein thrombosis	is D-dimer testing or	ultrasound	more accurate for diagnosis?
Prognosis	Do healthy adults over 70	who receive the flu vaccine	compared to not receiving the vaccine	have a lower risk of developing pneumonia during flu season?
Etiology	Do adults	who smoke	compared to those who do not smoke	have higher mortality rates?

Patient/Population/Problem	Intervention	Comparison/Control	Outcome	Time period
In adult patients with total hip replacement	how effective is PCA pain medication	compared to prn IM pain medication	in controlling pain	during the postoperative and recovery period?
Are 30- to 50- year old women who have high blood pressure		compared to those without high blood pressure	at increased risk for an acute myocardial infarction	during the first year after hysterectomy?
In urban African Americans with hypertension	does telemonitoring blood pressure		improve blood pressure control	within six months of initiation of medication?

Search tips: begin with a search using only the P AND I terms to retrieve a large result set which you can narrow down using terms for C and O. Consider terms that apply to your search such as: gender, age, time period, or type of study. You may also peruse the results list, abstracts or the full text of articles to view the C and O elements.

Keep in mind, you may not have all the pieces depending on your question type, but PICO is a great way to get started.

PICO search tools

There is a PICO search option on the Sirota Library's homepage.

Trip (Turning Research Into Practice) simultaneously searches evidence-based sources of systematic reviews, practice guidelines, and critically-appraised topics and articles. It also searches MEDLINE’s Clinical Queries, medical image databases, e-textbooks, and patient information leaflets.