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.
Step 1: Familiarize yourself with the PICO formula. P (Patient, problem, population), I (Intervention, prognostic factor, exposure), C (Comparative intervention, comparison), O (Outcome).
Step 2: Apply your clinical scenario to PICO. Here is an example:
Mr. Johnson is a 44-year old car mechanic with chronic back pain due to a herniated disc sustained 7 months ago. His therapists are considering using transcutaneous electrical nerve stimulation (TENS) to alleviate the pain. He asked if he could have acupuncture as an alternative.
Step 3: Once you have identified your PICO components, you can format them into a question, statement or clinical question.
Although, there is no singular model for structuring your clinical question, you want to ensure that your statement includes the PICO components.
Example Formula 1: In (Patient/Population/Problem), how does (Intervention) affect (Outcome) when compared with (Comparison)?
Example Question1: In adults with herniated discs, how does transcutaneous electrical nerve stimulation affect pain when compared with acupuncture?
Example Formula 2 with no Comparison: Does (Intervention) influence (Outcome) in patients who have (Problem)?
Example Question 2 with no Comparison: Does transcutaneous electrical nerve stimulation influence pain relief in patients who have herniated discs?
Step 4: After you formulate your question, you can make a list of synonyms of the PICO components. This will be helpful for searching the literature.
