Using PICO to create answerable clinical questions

When asking clinical questions, a framework such as PICO can help form an answerable question and make searching for an answer easier.

PICO stands for:

Patient Problem, (or Population)

This would be the patient's condition or disease, and could also include the population group (e.g. pregnant women, people over 80 years old)

Intervention (or exposure)

This could be the treatment, exposure or test that you want to find out about in relation to the clinical problem and could be an intervention such as a surgical procedure, drug treatment, or change in diet, or it could be an exposure to an environmental hazard, a physical feature (such as being overweight), or it could be a diagnostic test.

Comparison or Control

This might be an alternative or control strategy, exposure or test for comparison with the one you are interested in. A Comparison is not always present in a PICO framework.

Outcome

This would be what you (or the patient) wants to happen (or stop happening)

Example:

Clinical question:
β€˜In patients with recurrent furunculosis, do prophylactic antibiotics, compared to no treatment, reduce the recurrence rate?’

P Population/patient = patients with recurrent furunculosis
I Intervention/indicator = prophylactic antibiotics
C Comparator/control = no treatment
O Outcome = reduction in recurrence rate of furunculosis

More examples of answerable clinical questions

  • Among toddlers with recurrent nasal discharge, does the use of antibiotics affect the probability of recurrence?
  • In infants born prematurely, compared to those born at full term, what is the subsequent lifetime prevalence of sensory deafness?
  • Should we use hypothermia units to lower temperatures in febrile patients?
  • Should hyper-oxygenation always be provided prior to endotracheal suctioning?