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Occupational Therapy/Physical Therapy

Asking Good Questions

The key to finding appropriate evidence is to ask a searchable, answerable question.  The PICO framework is often used as a guide for asking clinical questions.

= patient, problem, population
I  = intervention
C = comparison intervention, control
O = outcome(s)

Have you noticed resources that refer to PICOT instead of PICO?  Some EBP experts add T to the standard PICO framework.  The T usually stands for time and can be helpful in making sure you're thinking of the appropriate time frame for your intervention and/or outcomes.

How to Build a PICO Question

Video created by Show Me The Evidence.

PICO Examples

Example 1

You have a patient who has difficulty exercising due to COPD and you wonder if pursed lip breathing techniques may improve their endurance.

P = patients with COPD

I = pursed lip breathing

C = regular breathing

O = improved exercise endurance

"In patients with COPD, does using pursed lip breathing, as compared to regular breathing, improve exercise endurance?"

Example 2

You are working with a recent stroke patient who is having balance issues and you are considering using virtual reality in their therapy.

P = recent stroke, balance issues

I = virtual reality

C = no virtual reality

O = improved balance

"In recent stroke patients, how does using virtual reality affect or improve balance?"

Example 3

Your patient is a recent veteran who is experiencing insomnia and you wonder how effective sleep restriction therapy might be in improving her sleep patterns.

P = insomnia

I = sleep restriction therapy

C = no therapy

O = improved sleep patterns

"In recent veterans with insomnia, how effective is sleep restriction therapy at improving sleep patterns?"