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Evidence-Based Practice Research in Nursing

Information and resources for research in Evidence-Based Practice


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


Premature infants transition too early from the safety of the womb into the unprotected world of the NICU environment and are unable to handle many of the stimuli required to sustain life. Music therapy is an emerging intervention that may help stabilize the negative physiologic changes during exposure to stressors in the NICU.


For this scenario, we can build our PICO question like this:

P- premature infants in the NICU

I-  music therapy

C- no comparison (null comparison)

O- reduction of negative physiological responses (or any positive changes)

Using PICO, we can formulate a focused, answerable question:

“For premature infants in the NICU, does music therapy reduce negative physiological responses?”



Brown, D. (2020). A Review of the PubMed PICO Tool: Using Evidence-Based Practice in Health Education. Health Promotion Practice21(4), 496–498.

Question Types

                                                                                      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 - illness caused by medical examination or treatment)

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: Duke University Medical Center Library & Archives - Evidence-Based Practice: PICO