PICO
Good research hinges upon asking good questions. When doing research, it is helpful to break up your question into concepts. Doing this will enable you to conduct more effective searches. One helpful way to break up your question is by using PICO. PICO breaks your topic into component concepts:
P: Patient, population, or problem
I: Intervention
C: Control
O: Outcome
For example, let's pretend that you have a friend on the Baylor women's basketball team who read that drinking chocolate milk after her workouts will lead to greater post-workout recovery effects. She wants your help finding evidence that can tell her more about whether or not she should start drinking chocolate milk instead of her usual Gatorade to improve her post workout recovery. Using PICO, our question might look like:
P: Basketball Athletes
I: Chocolate Milk
C: Gatorade
O: Better recovery
Note that PICO is a useful but imperfect framework. It is there to help you map out your clinical question, however, certain parts of the framework can change depending on your needs. For example, you might change your population to athletes, or female athletes, or University athletes, depending on your research question.
PICOTT
There are two more components to add to our PICO that can help us with our research questions tremendously:
Type of Question
and
Type of Study
When we answer these two questions, our PICO framework becomes a PICOTT framework.
In order find the best research for our questions, first we need to know what type of question we are asking: therapy, diagnosis, prognosis, harm/etiology, or prevention?
After we know what type of question we are asking, we can match up our question to the best study design for our question.
| Type of Question | Study Design for Question* | Example |
|---|---|---|
| Therapy | RCT (randomized controlled trial) | Is this intervention more effective than another? |
| Diagnostic Test | Independent, prospective blind comparison to a gold standard | How accurate is this diagnostic test? |
| Prognosis | Cohort study-->case-control-->case series | What is the likely outcome, progression, or survival time for this condition? |
| Harm/Etiology | **RCT-->cohort study-->case-control-->case series | What are the possible causes of this condition or state of affairs? |
| Prevention | RCT-->cohort study-->case-control | How do we reduce the risk of disease? |
*In each case, a well-conducted systematic review is better than an individual study. A systematic review will compare several appropriately designed studies that have looked at the same question and then aggregate the results.
**While RCTs can answer harm questions, it should be noted that they are not intentionally chosen by reserachers to investigate questions of harm due to ethical considerations.
(Information from Evidence-Based Practice for Health Sciences Librarians, an Introductory Workshop, https://musc.libguides.com/ebpforhslworkshop)
