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BSN Year One & Two Nursing

Asking the Question - PICO

When beginning with evidence-based practice, the first step is defining the problem you are trying to solve. This is how researchers develop proposals for what they want to study. In a clinical setting, you may use this process for quality improvement, encourage practices that are evidence-based, or to develop a research study.

PICO(T) is a mnemonic that helps us create focused and well-built clinical questions by breaking down the information that is needed to answer a research question. 

   Patient population of interest / patient problem; What is the key problem of the patient trying to be addressed? How would you describe the patients you are interested in? What are the demographics?
I       Intervention or issue of interest, prognostic factor, exposure ; What main prognostic factor are you considering? What do you want to do for the patient? What test do you want to do or drug do you want to provide? What factors or exposures may affect the patient? Is the intervention a procedure, drug, test, questionnaire, time?
   Comparison of interest, alternative approaches to the problem or issue ; Are you looking at two different tests? A drug and a placebo? Intervention versus no intervention? Your question may not always have a specific comparison.
   Outcome, what is trying to be achieved ; What do you hope to achieve or accomplish or learn? Do you want to improve function, test scores? Patient-oriented outcomes. 
T     Type of Question, Type of Study ; What is the study design used to answer the question? What types of questions are trying to be answered? Try to identify the question scenario. Is it a prospective study, double-blind, or other?

Consider the type of question you are asking and the types of studies that could best answer it. When you have a well-focused question it is easier to determine the appropriate type of evidence needed. 

Remember, evidence-based medicine always begins and ends with the patient, what can you do to support or help your patient?


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