OHSU Library

LibGuides

Nursing

Asking Your Question (PICO)

Nursing: Asking Your Question (PICO)

Search

Enter Search Words

Library resources for the School of Nursing

Nursing

What is EBP?

Asking Your Question (PICO)

CINAHL

Evidence Appraisal

Glossary

Other Resources

Citation

Levels of Evidence

Tutorials and Help

Clinical Tools

Background vs. Foreground

Forest vs.
Trees

Evidence based practice requires that clinicians make use of the best research they can find to
help them in decision-making. To find that research efficiently, the clinician must ask a welldesigned clinical question with all the elements that will lead to finding relevant research
literature.
The first step in doing this is to determine the type of question: background or foreground. The
type of question helps to determine the resource to access to answer the question.
Background questions ask for general knowledge about a condition or thing.
Broad in scope - "The Forest"
Provides basics for a a greater grasp of concepts
Typically found in textbooks, encyclopedias and reviews
Have two essential components: Example: What causes migraines? or How often

PICO
Worksheet

should women over the age of 40 have a mammogram?

A question root (who, what, when, etc.) with a verb
A disorder, test, treatment, or other aspect of healthcare

PICO
Worksheet

The background question is usually asked because of the need for basic information. It
is not normally asked because of a need to make a clinical decision about a specific
patient.
Foreground questions ask for specific knowledge to inform clinical decisions or

PICO
Resources

actions.
Focused in scope - "The Trees"
Requires a grasp of basic concepts to fully comprehend
Typically found in journals and conference proceedings
Have 3 or 4 essential components (see PICO below)

PubMed PICO
Tool
TRIP Database
PICO Builder
UNC PICO
Tutorial

PICO
PICO is a mnemonic used to describe the four elements of a good clinical foreground
question:
P = Population/Problem - How would I describe the problem or a group of patients similar to
mine?
I = Intervention - What main intervention, prognostic factor or exposure am I considering?
C = Comparison - Is there an alternative to compare with the intervention?
O = Outcome - What do I hope to accomplish, measure, improve or affect?

PICO Examples

Element
of the
clinical
question

Patient
Describe
as

Intervention

Comparison

(or cause,

(optional)

prognosis)

Is there an

Outcome
What is the
clinical

accurately

What is the

alternative

outcome,

as possible

main

treatment to

including a

the patient

intervention

compare?

time horizon

or group

or therapy

Including no

if relevant?

of patients

you wish to

disease,

of interest.

consider?

placebo, a

Including an

different

exposure to

prognostic

disease, a

factor,

diagnostic

absence of

test, a

risk factor,

prognostic

etc.

factor, a
treatment, a
patient
perception, a
risk factor,
etc.

Example

In patients

do

with acute

antibiotics

none

reduce
sputum

bronchitis,

production,
cough or
days off?

Example

In children

what are the

in the

with cancer

current

management

treatments

of fever and
infection?

Example

Among

does

listening to

make a

family-

standard

tranquil

difference in

members

care,

music, or

the reduction

of patients

audio taped

of reported

undergoing

comedy

anxiety.

diagnostic

routines

procedures

Asking Different Types of Questions

Fill in the blanks with information from your clinical scenario:

THERAPY
In_______________, what is the effect of ________________on

_______________ compared with _________________?

PREVENTION
For ___________ does the use of _________________ reduce the
future risk of ____________ compared with ______________?

DIAGNOSIS OR DIAGNOSTIC TEST

Are (Is) ________________ more accurate in diagnosing
_______________ compared with ____________?

PROGNOSIS
Does ____________ influence ______________ in patients who have
_____________?

ETIOLOGY
Are ______________ who have _______________ at ______________
risk for/of ____________ compared with _____________
with/without______________?

MEANING
How do _______________ diagnosed with _______________ perceive
__________________?
Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice
in nursing & healthcare: A guide to best practice. Philadelphia: Wolters
Kluwer/Lippincott Williams & Wilkins.

Last Updated: Jul 21, 2016 3:07 PM

Subjects: Nursing

URL: http://libguides.ohsu.edu/nursing

" Print Page

Login to LibApps
Report a problem.