Evidence-Based Practice: PICO(T) for Clinical Questions
This guide will help you work through the process of Evidence-Based Practice.
- Introduction to EBP
- 1. AskToggle Dropdown
- 2. Acquire
- 3. Appraise
- 4. Apply
- 5. Assess
- Study Design
- Resources about EBP
Creating a Clinical Question: PICO / PICOTS
Choose a topic of your interest to create a model of a PICO question, Upload your PICO question on this link. Add at least two references.
· Patient or Population or Problem The disease or condition you are investigating, and the particular demographic you are wanting to learn about (if applicable)
· Intervention or Indicator Primary treatment option
· Comparison or Control Comparison treatment (if applicable)
· Outcome What you you expect to see?
In addition to the major PICO components, there are two additional factors you may want to include in your question:
· Timeline**: Time it takes to demonstrate a clinical outcome or how long patients are observed.
· Study Type: What kind of study would best answer this question (i.e., RCT, Case Series, etc.). Rather than using keywords in your search strategy, you can often use filters to limit to specific study types / designs.
** Note that the timeframe does not always show up in the abstract. If you aren’t getting enough results, you may need to remove this from your search, and just eliminate results that don’t fit your preferred timeframe in the Prisma screening section.
Want to see an example in action? Check out the video below, or scroll down to see an example of how to transform a PICOT question into a search strategy.
PICO example begins at the 4:43 mark.
PICOT Example
Does telemonitoring blood pressure (I) in patients with hypertension (P) affect blood pressure control (O) within one year of initiation of the medication (T)?
Patient or Problem = hypertension
KEYWORDS: hypertension, high blood pressure, hypertensive
Intervention = telemonitoring blood pressure
KEYWORDS: telemonitor, telemedicine, MeSH term is “Blood Pressure Monitoring, Ambulatory”
Comparison = n/a
Outcome = improve blood pressure
MeSH term is “Blood Pressure” (but if you are using terms for “telemonitoring blood pressure,” this is unnecessary).
Timeframe = within one year
one year, twelve months (searching for timeframes can be tricky — this won’t find studies that were less than 12 months! If your results are too limited, you can try removing this from your search).
Potential search strategy:
hypertension OR hypertensive OR high blood pressure AND
telemonitor OR telemedicine OR “Blood Pressure Monitoring, Ambulatory”[Mesh] AND
one year OR twelve months
or if you search everything in a single line:
(hypertension OR hypertensive OR high blood pressure) AND (telemonitor OR telemedicine OR “Blood Pressure Monitoring, Ambulatory”[Mesh]) AND (one year OR twelve months)
What NOT to Do
“Table 1” is from:
Gallagher Ford, L., & Melnyk, B. M. (2019). The Underappreciated and Misunderstood PICOT Question: A Critical Step in the EBP Process. Worldviews on Evidence-Based Nursing, 16(6), 422–423. https://doi.org/10.1111/wvn.12408
Helpful Resources
· PICO Tutorial from University of Washington
· Johns Hopkins EBP Question Development Tool
Worksheet to help EBP teams develop an question that will answer a clinical, administrative, or knowledge problem.
This worksheet will help you build a PICOT question and identify keywords for your searchable question.
This tool uses predefined filters to help you quickly refine PubMed searches on clinical or disease-specific topics.
· The Underappreciated and Misunderstood PICOT Question: A Critical Step in the EBP Process
Please select a current topic and write a picot