Asking the Well Built Clinical Question

 Anatomy of a good clinical question: PICO(T)

PICO is a mnemonic that helps one remember the key components of a well focused question.  The question needs to identify the key problem of the patient, what treatment or tests you are considering for the patient, what alternative treatment or tests are being considered (if any) and what is the desired outcome to promote or avoid.

P= Patient Problem:

How would you describe a group of patients similar to yours? What are the most important characteristics of the patient? This may include the primary problem, disease, or co-existing conditions. Sometimes the gender, age or race of a patient might be relevant to the diagnosis or treatment of a disease.

I= Intervention, prognostic factor or exposure: 

Which main intervention, prognostic factor, or exposure are you considering? What do you want to do for the patient? Prescribe a drug? Order a test? Order surgery? Or what factor may influence the prognosis of the patient - age, co-existing problems, or previous exposure? 

C= Comparison: 

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, or two diagnostic tests? Your clinical question may not always have a specific comparison.

O= Outcome: 

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?

T = Time:

This is the time it will take for the procedure/outcome