Using PubMed in Evidence-Based Practice

Develop a Clinical Question

Using PICO to Frame Clinical Questions

To use evidence-based practice, you need a clear idea of the question you would like to answer. PICO is an acronym to help you formulate a clinical question and guide your search for evidence. Using this formula can help you find the best evidence available in a quicker, more efficient manner. Click on each letter for a description.


Think about the following scenario and use PICO to create a clinical question:

Physicians in your office recommend exercise to patients age 65 and older who have high blood pressure. However, you overhear patients express doubts. One patient tells his spouse that he does not know how exercise will help. Will patients follow their physicians’ recommendations for exercise? You are considering whether creating handouts and holding a class on the benefits of physical activity might encourage patients to exercise.

Using PICO, we identify:

P = Patient or Problem - Patients age 65 and older with high blood pressure

I = Intervention - Patient education

C = Comparison - No patient education

O = Outcome - Patient participation in exercise

From this list, we develop the clinical question, “Are patient education programs effective (compared to no intervention) in increasing patient exercise in the population of patients age 65 and older with high blood pressure?”

Doctor with older patient and nurse watching on.

(Image Source: iStock Photos, ©)

Try-It Exercise

Identify the PICO elements from the following scenario:

As a school nurse in a local high school, you notice an increase in teens that are vaping. You’d like to do some research into the possible negative health effects of vaping so that you can provide students with factual materials to help them stop or reduce their smoking.

  1. P = Patient or Problem - How would you describe your group of patients?  
  2. I = Intervention - What main intervention are you considering?  
  3. C = Comparison - What is the main alternative to compare with the intervention?  
  4. O = Outcome - What can you hope to accomplish, measure, improve or affect?