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Evidence Based Practice: PICO

Asking Questions

PICO is a useful tool for asking focused clinical questions.

Once you have formulated a focused clinical question using PICO, it is also useful to decide what type of question it is. 

PICO

When searching for answers to foreground questions, the recommended framework for structuring your search is PICO.  PICO stands for:

Patient

Intervention or Exposure

Comparison Intervention (frequently the comparison may be to take no action)

Outcome

These examples are taken from Guyatt, Gordon, et al.  Users' Guide to the Medical Literature.  2nd ed.  New York: McGraw Hill, 2008.

1.  What is the ideal gestational age for a term twin pregnancy in a 35-year-old woman who wants to know whether a planned cesarean section or planned vaginal delivery is associated with improved outcomes, specifically, mortality?

PICO Element Search Terms for PubMed
P(atient) Term twin pregnancy Term twin pregnancy
I(ntervention) Planned cesarean section Planned C-section
C(omparison) Planned vaginal delivery Vaginal delivery
O(utcome) Infant mortality Mortality

2.  In adults, is binge drinking compared with nonbinge drinking associated with an increase in mortality?

PICO Element Search Terms for PubMed
P(atient) Adults [Leave blank]
I(ntervention/exposure) Binge drinking Binge drinking
C(omparison) No binge drinking [Leave blank]
O(utcome) Mortality Mortality
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