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NRS401: Nursing Research Utilization: Clinical Questions & PICO

What is a Clinical Question?

Creating a clinical question helps medical professionals find the best possible research efficiently to help them make decisions regarding a patient's care. Clinical questions can be broadly categorized as either background or foreground questions.  

► Background Questions ask for general knowledge about a condition, test or treatment.  These types of questions typically ask who, what, where, when, how & why about things like a disorder, test, or treatment, or other aspect of healthcare.  Example: What are the clinical manifestations of menopause?

► Foreground Questions ask for specific knowledge to inform clinical decisions. These questions typically concern a specific patient or particular population. They tend to be more specific and complex than background questions.  Quite often, foreground questions investigate comparisons, such as two drugs, or two treatments.  Example: In patients with osteoarthritis of the hip, is water therapy more effective than land-based exercise in restoring range-of-motion? 

Source: Evidence-Based Practice in Health (Canberra)

What is PICO?

PICO is a mnemonic for the important parts of a well-built clinical question. PICO can also help formulate searching strategies by identifying the key concepts that need to be addressed in the article to answer the clinical question.

Evidence-Based Practice: PICO Research Guide (Duke)

^This Research Guide provides a comprehensive overview of Evidence-Based Practice & PICO. 

Helpful Links

Introduction to Evidence-Based Practiced Tutorials (Duke)

^This is a great online tutorial with sample case studies & activities to help you understand EBP.

Evidence-Based Practice in Health (Canberra)

^This link provides insight to different types of clinicals questions and their context in the medical field. 

PICO Elements of a Clinical Question

Examples of PICO Elements

Common Types of Clinical Questions

► Therapy Questions: 

how to select treatments to offer our patients that do more good than harm and that are worth the efforts and costs of using them.

► Diagnostic Tests:

how to select and interpret diagnostic tests, in order to confirm or exclude a diagnosis, based on considering their precision, accuracy, acceptability, expense, safety, etc.

► Prognosis Questions:

how to estimate a patient's likely clinical course over time due to factors other than interventions

► Harm/Etiology Questions: 

how to identify causes for disease (including its iatrogenic forms).

Source: Evidence-Based Practice: PICO (Duke)

Using PICO Elements When Searching