PICO Questions in Depth

What is a PICO question anyway?

Finding relevant medical information is often easier if you first develop a PICO question.  This is a way of formulating a medical question to better match the capabilities of database (MEDLINE, etc.) search engines. 

PICO is an acronym for:

  • Patient and Problem
    • How would you describe a group of patients similar to yours? What are the most important characteristics of the patient? This may include the primary problem, disease, or co-existing conditions. Sometimes the sex, age, or ethnicity of a patient might be relevant to the diagnosis or treatment of a disease.
  • Intervention
    • Which main intervention, prognostic factor, or exposure are you considering? What do you want to do for the patient? Prescribe a drug? Order a test? Order surgery? What factor may influence the prognosis of the patient? Age? Co-existing problems? What was the patient exposed to? Asbestos? Cigarette smoke?
  • Comparison
    • What is the main alternative to compare with the intervention? Are you trying to decide between two drugs, a drug and no medication or placebo, or two diagnostic tests? Your clinical question may not always have a specific comparison.
  • Outcome
    • What can you hope to accomplish, measure, improve or affect? What are you trying to do for the patient? Relieve or eliminate the symptoms? Reduce the number of adverse events? Improve function or test scores?

PICO Example:

Therapy
In a 4 year old boy requiring antibiotics, do probiotics decrease the risk of developing antibiotic associated diarrhea?

P = 4 yo male on antibiotics
I = probiotics
C = none/placebo
O = decrease the risk of antibiotic associated diarrhea

PICO terms can be used to create a potential search strategy to search relevent EBM and health databases. Since terminology in the health in filled with synonyms, you may need to list and search multiple terms for a single concept:

P = antibiotics, antimicrobial agents
I = probiotic, probiotics, lactobacillus, acidophilus
O = diarrhea

From this PICO, a good search strategy might look like this:

(antibiotics OR antimicrobial agents) AND (probiotics OR lactobacillus OR acidophilus) AND diarrhea

Try using a PICO Worksheet to convert your scenario into a search query and process to find relevant articles in EBM resources and databases.

Page last updated: June 18, 2012
Questions or suggestions? Contact the Clinical Sciences Team