Evidence-Based Practice Research in Nursing

PICO is a popular framework for formulating clinical questions, especially those relating to therapy (or intervention) effectiveness.  It’s used to develop a well-built clinical question to aid in creating a search strategy. It helps identify searchable aspects of a situation in which a patient or population has a certain condition, and the outcome of interest is related to a therapy or intervention. 

PICO stands for:

• P – Populations/People/Patient/Problem
• I – Intervention(s)
• C – Comparison (if any)
• O – Outcome

From Showmetheevidence.com

                                                                                      Image source: Dartmouth Libraries

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.