What is PICO? Why Use It?

PICO and PICOT are mnemonics used in evidence-based practice to help nurses frame a clinical question. PICOT is considered more contemporary than PICO because it includes a time frame, which may be important for understanding the duration of an intervention's effects.

By using a PICO or PICOT framework, the research question is comprehensive and focused. The PICO framework simplifies the search for and evaluation of evidence. It provides for structured evidence-based research that is efficient and effective, leading to relevant results that improve patient care and outcomes.

PICO(T) stands for:

  • P (Patient/Problem/Population): Who is the patient or what is the problem to study?
    • Examples: age, ethnicity, gender, and disease or condition.
  • I (Intervention/Treatment): What is the intervention or treatment being considered?
    • Examples: Medications, drugs, dosage levels and frequency, drug combinations, type of administration (e.g., oral, intravenous, topical), procedures, surgeries, therapeutic procedures, or lifestyle changes (e.g., diet, exercise behavioral)
  • C (Comparison): Are there alternatives to compare with the intervention?
    • Examples: alternative medicine, placebo, different treatment, or no treatment.
  • O (Outcome): What is the desired outcome? What outcome do you anticipate? What do you hope to improve or affect?
    • Examples: Improve the quality of life, minimize side effects, reduce pain, or improve function
  • T (Time): Over what period of time will the intervention be measured?

How to Formulate a PICOT Statement

To formulate a PICOT question, break down a clinical or research question in the four or five key components: Patient/Problem, Intervention, Comparisons, Outcome, and Time.

Sample PICOs

Below are examples of PICO questions covering different helathcare topics.

For adults with hypertension (P), do telehealth consultations (I), compared to in-person consultations (C), result in better blood pressure control (O) over a period of three months?

  • P (Patient/Problem): Adults with hypertension
  • I (Intervention): Telehealth consultations
  • C (Comparison): In-person consultations
  • O (Outcome): Blood pressure control
  • T (Time): Over a period of three months

In children and adolescents with Tourette Syndrome, how does behavioral therapy (CBIT) compared to pharmacological treatment affect tic severity and quality of life?"

  • P (Population/Patient): Children and adolescents diagnosed with Tourette Syndrome
  • I (Intervention): Behavioral therapy (e.g., Comprehensive Behavioral Intervention for Tics [CBIT])
  • C (Comparison): Pharmacological treatment (e.g., dopamine receptor blockers)
  • O (Outcome): Reduction in tic severity and improved quality of life

In hospital nurses, how does participation in a mindfulness-based stress reduction (MBSR) program compared to standard workplace support affect stress levels and job satisfaction?

  • P (Population/Patient): Hospital nurses experiencing work-related stress
  • I (Intervention): Mindfulness-based stress reduction (MBSR) programs
  • C (Comparison): No structured stress reduction program or standard workplace support
  • O (Outcome): Decreased stress levels, improved job satisfaction, and reduced burnout

For a broader range of examples, try searching for opens new window Cochrane reviews and explore the variety of PICO examples.

Using an AI Tool

Use AI tools, such as ChatGPT, for brainstorming, to gain new perspectives, and to explore optional components to your key idea.

ChatGPT
opens new windowhttps://chatgpt.com/

AI question and answer, conversation generating tool. v3.5 is free.
- Large language model that generates text, answers questions, engages in conversation and provides assistance with various topics.
- Uses information from books, articles, websites, and other publicly accessible texts available up to January 2022.

  • Use natural language to key in an idea or topic and ask for a lists of keywords, subject headings, databases to search, Boolean search strings, or important scholars relevant to a topic.
  • Key in a prompt for a sample outline or PICO, then expand relevant points or sections.
  • Continue to build and extract information using effective prompt engineering.

NOT effective for gathering research articles, creating citations, or reference lists.

See: opens new windowNursing Research: AI Tools

Using the PICO Search in CINAHL Ultimate

To search using PICO:

  1. On the CINAHL Ultimate search screen (basic or advanced), click the PICO Search link below the search box.
  2. Reduce your question into specific keywords and enter them in the PICO search box fields. ...
  3. After entering your terms, click Submit.
  4. Your results are displayed.