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.
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 |