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Nursing Research: PICO Clinical Questions

Support for researching evidence-based practices.

PICO is an acronym for the four elements that every well-designed clinical question must have when researching evidence-based practices. 

Creating an effective search strategy with PICO

There are four key elements required for an effective PICO question.

P: Population / Patient

  • Who or What?  Patient, Population, Problem.
  • How would you describe a group of patients similar to your group?
  • What are the most important characteristics of the patient?  Primary problem; disease; co-existing conditions.
  • Consider sex, age and/or race of a patient as this may be relevant to the diagnosis or treatment of a disease.

 I: Intervention / Indicator

  • Intervention, prognostic factor or exposure - Drug, procedure, diagnostic test, exposure.
  • Which main intervention, prognostic factor, exposure are you considering?
  • What do you want to do for the patient? Prescribe a drug? Order a test? Order surgery?
  • What factor might influence the prognosis of the patient? Age; co-existing problems.
  • What exposure has the patient experienced? Asbestos; cigarette smoke.

 C: Comparator / Control

  • What is the main alternative?  Comparison or intervention?
  • 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; two diagnostic tests.
  • Your clinical question may not always need a specific comparison.

 O: Outcome

  • What are you trying to accomplish, measure, improve, effect, achieve?
  • 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.

Example

Clinical problem: A patient asks if drinking carrot juice will reduce the likelihood of developing prostate cancer.

Answerable clinical question:

P - In males

I - Does drinking carrot juice

C - Compared to not drinking carrot juice

O - Reduce the incidence of prostate cancer

Created by Katrina Henderson at Griffith University

Shared under Creative Commons Attribution 4.0 International (CC BY 4.0) license

 

References

DiCesno, A., Bayley, L., & Haynes, B. (2009). Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model. Evidence Based Nursing, 12(4). https://doi.org/10.1136/ebn.12.4.99-b

eHealth NSW. (2018). Clinical Information Access Portal (CIAP) EBP Learning Modules. https://www.ciap.health.nsw.gov.au/training/ebp-learning-modules/module1/index.html

Glossary of basic statistical terms

Null and Alternative Hypothesis

The null and alternative hypotheses are two competing claims that researchers weigh evidence for and against using a statistical test:

  • Null hypothesis: There’s no effect in the population.
  • Alternative hypothesis: There’s an effect in the population.

(Scribbr, May 6, 2022. Learn more...)

Dependent and Independent Variables

In research, variables are any characteristics that can take on different values, such as height, age, temperature, or test scores. Researchers often manipulate or measure independent and dependent variables in studies to test cause-and-effect relationships.

  • The independent variable is the cause. Its value is independent of other variables in your study.
  • The dependent variable is the effect. Its value depends on changes in the independent variable.

(Scribbr, Dec. 2, 2022. Learn more...)

Subject variables

Subject variables are characteristics that vary across participants, and they can’t be manipulated by researchers. For example, gender identity, ethnicity, race, income, and education are all important subject variables that social researchers treat as independent variables.

Example

Clinical problem: A patient asks if drinking carrot juice will reduce the likelihood of developing prostate cancer.

Answerable clinical question:

P - In males (independent subject variable)

I - Does drinking carrot juice (independent variable)

C - Compared to not drinking carrot juice (independent variable)

O - Reduce the incidence of prostate cancer (dependent variable)

Bhandari, P. (2022, December 02). Independent vs. Dependent Variables | Definition & Examples. Scribbr. Retrieved April 18, 2023, from https://www.scribbr.com/methodology/independent-and-dependent-variables/

More information on statistical analysis can be found on the Scribbr website: The Beginner's Guide to Statistical Analysis | 5 Steps & Examples on scribbr.com.

Video Tutorials - Researching Evidence Based Practices

Researching evidence based practices is key to nursing education. These video tutorials provide a step-by-step approach for doing nursing research at Bushnell University.   

Search Strategies

PICOT Research Question Generator

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