LibGuides: Nursing 563: Creating a Clinical Question

Creating a Clinical Question: PICO / PICOT

For this assignment, you'll need to create a searchable question using the PICO(T) format. Once you have your PICO(T) question, you can then extract search terms that can be used to find research in a database.

You will need to post your PICOT question to the discussion board and get it approved by your instructor before moving on to finding research. If you are having trouble developing a PICOT question, please make an appointment to talk to your instructor.

EBP questions are focused towards answering a specific problem or process; this is generally posed towards improving patient care. On the other hand, quality improvement (QI) questions are higher level questions that are aimed at systemic changes such as efficiency and workflow processes. PICOT is specifically used to answer EBP questions.

Your problem will guide your question and whether you will use PICOT or other tools to help you formulate your question. If your topic leads to a Qualitative question, see the Qualitative Research guide to help you form your question.

PICOT for Clinical Interventions

PICO is an acronym that can help you create a well-built clinical question by identifying the key aspects of a complex patient presentation.

Patient of 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 (optional) factors that 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.).

** 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.

PICOT Example

Does telemonitoring blood pressure (I) in patients with hypertension (P) improve blood pressure control (O) within one year of initiation of the medication (T)?

Patient or Problem = `hypertension`	SEARCH TERMS: hypertension, high blood pressure, hypertensive
Intervention = `telemonitoring blood pressure`	SEARCH TERMS: telemonitor, telemedicine, MeSH term is “Blood Pressure Monitoring, Ambulatory”
Comparison = n/a
Outcome = `affect blood pressure`	SEARCH TERMS: MeSH term is “Blood Pressure” (but if you are using terms for “telemonitoring blood pressure,” this is unnecessary).
Timeframe = `within one year`	SEARCH TERMS: one year, twelve months Note: searching for timeframes can be tricky -- this search won't bring up studies that are 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

If you search everything in a single search string:

(hypertension OR hypertensive OR high blood pressure) AND (telemonitor OR telemedicine OR "Blood Pressure Monitoring, Ambulatory"[Mesh]) AND (one year OR twelve months

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

Nursing 563

Creating a Clinical Question: PICO / PICOT

PICOT for Clinical Interventions

PICOT Example

Does telemonitoring blood pressure (I) in patients with hypertension (P) improve blood pressure control (O) within one year of initiation of the medication (T)?

Potential search strategy:

Resources