Must A PICOT Question be written in Order?
Ideally, most nursing students ask whether a PICOT question must be in the Order of the mnemonic PICOT. An ideal answer would be that although writing a PICOT question in order is preferred, there is nothing wrong with writing it in any order because the format can vary. However, you are good to go if your clinical research question has all the PICOT components and addresses an evidence-based nursing issue. Besides, the goal of writing and the type of study you are doing will most likely determine how you organize your PICOT question.
Below are examples of PICO questions that do not follow the conventional linear arrangement.
- Does metformin have high efficacy (I) compared to rosiglitazone (C) when used for glycemic control (O) for children with type 2 diabetes (P)?
- Is handwashing (I) among nurses attending to patients in the burn unit minimize (P) hospital-acquired infections (O) compared to alcohol-based hand sanitizers (C)?
- Can brief intervention (I) be used as an effective smoking cessation technique(O) for teenagers (P) in high school compared to smoking bans and educational programs (C)?
As you can see from the PICO examples above, you don't necessarily have to write a PICO question in the Order. Rather, if you are asked, for instance, to write a question relating to harm or etiology, swap the I for an E, where E stands for the exposure that a patient experiences.
And because after writing your question, you need to conduct a search strategy, you need to break down every component further. In this case, add two Ts to the PICO mnemonic. So, now for your search strategy, you will have the components below:
Patient (population or problem),
Intervention (prognostic factor or exposure),
Comparison,
Outcome,
Type of Question, and
Type of Study (PICOTT).
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