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Gerstein Science Information Centre

Evidence-Based Practice

Classic Question Formulas

1. PICO(T)

PICOT is a tool for distilling the essential components of a clinical scenario into concepts to help you identity you clinical question. Finding relevant medical information is often easier if you break down your scenario by developing a PICOT question. PICOT is an acronym for:
 
Patient / Population / Problem: How would you describe this group of patients similar to yours? What are the most important characteristics of the patient(s)? what sorts of participants, from where, with what features? What is the health problem you are investigating? 
 
Intervention: the treatment, drug, or technology; what is the exposure? What dose? 
 
Comparison: What is the main alternative to compare with the intervention? At times your question may not have a comparison!
 
OutcomeWhat are you aiming to accomplish, measure, improve, make an impact on? Are you trying to eliminate or relieve symptoms? Reduce the number or severity of adverse effects? Improve functions?
 
Type of studyDepending on your question, you might also include a fifth line on Type of Method/Study, in which you would specify the type of study you will look at.Sometimes T stands for time factors - 1 year after? 3 months?

 

EXAMPLE: Does exercise in comparison with diet reduce the incidence of people with heart disease from experiencing a heart attack?

Patient or Population: People with heart disease, ie. who have had a cardiac event

Intervention: Moderate exercise

Comparison: Dietary changes, medications

Outcome: Reduction in incidence of heart attacks and mortality rates from heart disease

Notice how this structure forces the researcher to be more specific. With an example like this one, you would also want to clearly define each term.

 

2. PIE

Like PICO, PIE it is a way to focus a topic into a concise clinical question. PIE is better suited for qualitative research questions. PIE is an acronym for: 
 
Patient / Population / Problem: How would you describe this group of patients similar to yours? What are the most important characteristics of the patient(s)?             
 
Intervention / Issue: Which is the main prognostic factor, intervention, treatment, or exposure you are considering? What do you want to do for the patient? What other factors can influence the prognosis?
 
Evaluation / Effect (method): What methods are being used or most appropiate to evaluate the outcome? Clinical queries? Trials? Focus groups? What are you trying to measure?