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Evidence Based Practice Tutorial

Ask the Right questions with PICO

PICO is a State of Mind

It helps to get into a mindframe that will help you formulate your question and think deeply about how best to answer it through the research process. There are several ways to formulate a PICO question too, so each question takes a bit of a different form.

Asking the Right Questions

A good question…

  • Focuses on your information needs
  • Identifies crucial search concepts
  • Points you in the direction of potential resources

Form Your Questions







P – Population or Patient or Disease

Characteristics of a population (age, gender, ethnicity, etc) within a specific condition or set of circumstances. Example: Sudanese Refugees

I -Intervention or Exposure

Specific Drug, therapy, or Procedural Intervention

Exposure to certain conditions or risk behavior

Alternative diagnostic tool or procedure

Specific drug or procedural intervention

Specific drug, therapy, or procedural intervention

C – Comparison

Alternative drug, therapy,  or procedural intervention

Absence of certain conditions or risk behavior

Alternative diagnostic tool or procedure

Alternative drug or procedural intervention

Alternative drug, therapy, or procedural intervention

O – Outcome

Management of disease/condition

Development of disease/condition

Effective diagnosis of condition

Prevention of Disease/condition

Occurrence or absence of new condition

T – Time Frame

The time it takes to demonstrate an outcome or the period in which patient are observed. Examplethe six month period following childbirth.


PICO questions are typically used in Nursing and most clinical health research.

Using the COPES (Client-Oriented, Practical Evidence Search) Framework to Ask Evidence-Based Questions

Copes Questions

Client Type and Problem [1]

What you Might Do [2] Alternative Course of Action [3] What you aim to Accomplish [4]

Across:  Four elements of a good question.


DOWN: Five Question Types

Describe the group of clients; be specific about characteristics. Apply a treatment; actions to prevent a problem; measures to assess a problem; client surveys; screening to assess risk alternatives or comparisons of interventions to the methods proposed in column [2]. the outcomes of the treatments from [2] and/or [3]. were there valid measures? Accurate risk estimation, prevented behavior, accurate estimation of need?
Effectiveness If disoriented elderly persons living in residential nursing homes are given reality orientation therapy or validation therapy which will result in better orientation to time, place, and person?
Prevention If sexually active high school students at high risk for pregnancy are exposed to sex education that includes instruction on proper use of birth control methods or Baby-Think-It-Over which group will have knowledge of birth control methods/use birth control methods/have fewer pregnancies?
Assessment If aged residents of a nursing home with alzheimer's or dementia may have depression are administered depression screening tests or a short mental status examination which measure will be the briefest, most inexpensive, valid and reliable test to differentiate between depression and dementia?
Description If family members of persons diagnosed with Aphasia meet for a support group and receive a short client satisfaction questionnaire given to all support group participants   which areas will the clients list as their ares of greasts and least satisfaction?
Risk If those calling a crisis line for a battered women's shelter are administered a risk assessment scale via telephone or are assessed only by the answerer's "practical judgement" without a scale then will the risk scale have a higher reliability and predictive validity regarding future violence?


COPES questions are typically used in Social Work and some other helping professions as a question framework.

PICO Question