PICO Questions

PICO, or sometimes PICOT,  helps formulate the search strategy by identifying the key concepts that need to be in the article that can answer the question.

PICO or PICOT stands for the following:

 PATIENT OR PROBLEM

How would you describe a group of patients similar to yours? What are the most important characteristics of the patient?

 INTERVENTION, EXPOSURE, PROGNOSTIC FACTOR

What main intervention are you considering? What do you want to do with this patient?

 COMPARISON

What is the main alternative being considered, if any?

 OUTCOME

What are you trying to accomplish, measure, improve or affect?

Sometimes a T is added to the PICO formula, becoming PICOT.

The T can stand for several different items.

 Type of Question

Therapy / Diagnosis / Harm / Prognosis / Prevention

 Type of Study

Systematic review / RCT / cohort study / case control

 Time

Span of time

Primary Question Types

• Therapy: how to select treatments to offer our patients that do more good than harm and that are worth the efforts and costs of using them.
• Diagnostic tests: how to select and interpret diagnostic tests, in order to confirm or exclude a diagnosis, based on considering their precision, accuracy, acceptability, expense, safety, etc.
• Prognosis: how to estimate a patient's likely clinical course over time due to factors other than interventions
• Harm / Etiology: how to identify causes for disease (including its iatrogenic forms).

Other Question Types

• Clinical findings: how to properly gather and interpret findings from the history and physical examination.
• Clinical manifestations of disease: knowing how often and when a disease causes its clinical manifestations and how to use this knowledge in classifying our patients' illnesses.
• Differential diagnosis: when considering the possible causes of our patient’s clinical problem, how to select those that are likely, serious and responsive to treatment.
• Prevention: how to reduce the chance of disease by identifying and modifying risk factors and how to diagnose disease early by screening.
• Qualitative: how to empathize with our patients’ situations, appreciate the meaning they find in the experience and >understand how this meaning influences their healing.

From: Sackett, DL. Evidence-based medicine: how to practice and teach EBM.