Forming a Question -- PICO
To effectively search for the best evidence, you need to determine which details are most important to the situation at hand. The PICO formula helps clinicians extract the essential details and then re-configure them into a well-built clinical question.
A well-built clinical question needs to be directly relevant to the patient or problem at hand, and phrased in such a way as to facilitate the search for the answer. With PICO, this process is made easier! It helps formulate your search strategy by identifying the key concepts that need to be in the literature that can answer your question.
Components of PICO include:
Patient/population or problem
What are the most important characteristics of the patient? What is the primary compliant of the patient or patient group?
All of the following can be used to help define the population:
- Age, race, and sex
- Clinical setting
- Comorbidities
- Geographic location
Intervention or variable of interest
What main intervention are you considering? What do you plan on doing for the patient? -- can include exposure to a disease, risk behavior, or prognostic factor.
Comparison
Is there a control or alternative strategy you would like to compare to the intervention? -- can include a placebo, an alternative strategy, or another prognostic factor.
Comparing against standard care or nothing (null) is also a potential option.
Outcome
What are you trying to accomplish, measure, affect, or improve? -- can include risk of disease, accuracy of a diagnosis, or rate of occurrence of adverse outcome.
The goal of PICO is to focus your topic. Do not worry if your question does not fit perfectly into the PICO format. Your question can always be redefined and change.
