Pattern, Order, Style, or Formats of PICOT Questions
Once you have the components of your PICOT formula, you can frame your question in 6 different ways depending on the goal/target, the nursing practice problem, or the healthcare issue you are addressing. You can use these PICO formats as a template for asking PICOT questions.
1. Examining a Diagnosis
These questions relate to or address the actions or processes of identifying or determining the cause and nature of a disease, injury, or disorder through evaluation.
Are (is) _________ (
I) more accurate in diagnosing ________ (
P) compared with ______ (
C) for _______ (
O)?
Example:
- In middle-aged males with suspected myocardial infarction (P) are serial 12-lead ECGs (I) compared to one initial 12-lead ECG (C) are more accurate in diagnosing an acute Myocardial infarction (O)?
- For deep vein thrombosis patients (P), does the use of D-dimer testing (I)versus ultrasound (C) result in a more accurate diagnosis (O)?
2. Exploring Etiology
These are specific questions that address the origins or causes of a disease or disorder, such as the risk factors.
Are____________________ (
P), who have ____________________ (
I) compared with thosewithout ____________________(
C) at ____________ risk for/of____________________(
O) over ________________(
T)?
Examples:
- Are 30- to 50-year-old women (P) who have high blood pressure (I) compared with those without high blood pressure (C) at increased risk for an acute myocardial infarction (O) during the first year after hysterectomy (T)?
- Do adults (P) who binge drink (E/I) compared to those who do not binge drink (C)have higher mortality rates (O)?
3. Investigating Intervention, Therapy, or Treatment
These are questions that address specific treatment approaches for illnesses or disabilities.
In
_______(P), what is the effect of
_______(I) on
______(O) compared with
_______(C) within
________ (T)?
Examples:
- In children with spastic cerebral palsy (P), what is the effect of splinting and casting(I) compared to constraint-induced therapy (C) on two-handed skill development (O)?
- In African-American female adolescents with hepatitis B (P), how does Acetaminophen (I), compared to ibuprofen (C), affect liver function (O)?
- In patients with osteoarthritis of the knee (P), is hydrotherapy more effective (I) than traditional physiotherapy (C) in relieving pain (O)?
4. Investigating Meaning
These are questions that address how one experiences a given phenomenon.
How do
________ (P) diagnosed with
_______ (I) perceive
______ (O) during
_____ (T)?
Examples:
- How do young males (P) with a diagnosis of below-the-waist paralysis (I) perceive their interactions with their significant romantic others (O) during the first year after their diagnosis (T)?
- How do pregnant women (P) newly diagnosed with diabetes (I) experience reporting their blood sugar levels (O) to their healthcare providers?
5. Discussing viable Prevention Strategies
These questions relate to preventing diseases, medical errors, or factors that impact health and healthcare services.
For
________ (P) does the use of
______ (I) reduce the future risk of
________ (O) compared with
_________ (C)?
Examples:
- For adolescents smoking cigarettes (P), does the use of personalized counselling (I) reduce the risks of chronic respiratory illnesses (O) compared with group therapy (C)?
- For women in their 20 weeks of pregnancy (P), does maintaining a regular exercise routine (I) reduce the risk of preeclampsia (O) compared to no exercise (C)?
- For obese children (P), does the use of community recreational facilities (P) compared to educational programs on lifestyle changes (C) reduce the risk of diabetes mellitus (O)?
6. Investigating Prognosis or Prediction
These are questions that address the prediction of the cause of a disease.
Does
__________ (I) influence
________ (O) in patients who have
_______ (P) over
______ (T)?
Examples:
- In patients who have experienced an acute myocardial infarction (P), how does being a Smoker (I) compared to a non-smoker (C) influence death and infarction rates (O) during the first five years after the myocardial infarction (T)?
- For patients 65 years and older (P), how does the use of an influenza vaccine (I) compared to not receiving the vaccine (C) influence the risk of developing pneumonia (O) during flu season (T)?
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