What is PICO(T) and how do I use it to formulate a clinical question for searching the biomedical literature?

Answered By: APUS Librarians

Last Updated: Jan 22, 2025 Views: 1174

WHAT IS PICO?

PICO is an acronym used to formulate a strong clinical question that is also used to create strong search strategies for finding the best evidence. Use these steps to create and apply a PICO search strategy:

Organize the concepts in your clinical question using PICO.
Identify the keyword/s that represent the concepts to create a strong search strategy.
Test the search strategy in a biomedical literature database, including PubMed or CINAHL. Check results for relevancy, adding additional medical subject terms as keywords as needed.
Apply or remove database limits as needed.
Review results.

HOW DO I USE PICO?

How to Perform a PICO Search: View this video to learn how to perform a PICO Search

7 Steps to the Perfect PICO Search - CINAHL: In this document, explore the importance or evidence-based nursing practice, take a deeper dive into the PICO process and provide an example of the PICO process in action through a case scenario.

Example

Clinical question: Does hand sanitizing reduce hospital-acquired infections as well as handwashing with soap?

1. Organize the concepts in your clinical question using PICO:

PICO	Concept
Population/Problem=	hospital-acquired infections
Intervention=	hand sanitizer
Comparison=	soap and water
Outcome=	reduced hospital-acquired infections

2. Identify the keyword/s that represent the same concepts to create a strong search strategy

PICO	Concept	Keywords & Medical Subject Headings
Population/Problem=	hospital-acquired infections	hospital-acquired infection OR cross-infection OR nosocomial infection
Intervention=	hand sanitizer	hand sanitizer OR hand sanitizing OR handwashing methods
Comparison=	soap and water	N/A (Omit for comparisons against standard practice)
Outcome=	reduced hospital-acquired infections	prevention

3. Test the search strategy in a medical literature database, including PubMed or CINAHL.

4. Check results for relevancy, adding additional medical subject terms as keywords as needed. Apply or remove database limits as needed. For a comprehensive search, remove the full-text limit.

5. Review results.

For more help using PICO in specific databases:

Learn more:

Creating your PICO Questions (in Applying Research in Practice, by Dr. Duy Nguyen)
Examples of a PICO/T Process (in Fast Facts for Evidence-Based Practice in Nursing: Implementing EBP in a Nutshell, by Maryann Godshall)
How to Formulate a Query: PICO (inResearch Methodology in the Medical and Biological Sciences, by Petter Laake, et al.)