For Evidence Based Practice (EBP) searches, you will often be expected to break down your question into its key concepts using an EBP formula such as PICO, PIO or PEO.
Using a framework like PICO can be useful as it prompts you to make a clear, structured and focussed question. It ensures that you include the important elements of a clinical research area: Patient, Intervention/Issue/Exposure, Comparison (if appropriate) and Outcome, which then creates a structure for your search strategy.
PICO questions and PIO questions may focus on quantitative or qualitative research. When there is no comparison element, as with many qualitative research questions, the search strategy can be defined as following a PIO model. The I part of the framework may focus on a specific intervention that a patient/population group has received or it could be a particular issue that a patient/population group faces.
PEO questions are generally used for qualitative research where the population has been exposed to a condition or illness (e.g. dementia), to a risk factor (e.g. smoking), to screening, to rehabilitation or to a service.
Who is the question about?
What is happening or being done to P?
What could be done instead of I?
What has happened to P as a as result of I?
In patients at high risk for gallbladder dysfunction (P) is a HIDA scan (I) compared with an ultrasound (C) more accurate in diagnosis (O)?
Patient | Patients with gallbladder dysfunction |
Intervention | HIDA scan |
Comparison | Ultrasound |
Outcome | Diagnosis |
In obese females (P), how does weight loss (I) compared to daily administration of ACE inhibitors (C) affect blood pressure (O)?
Patient | Obese females |
Intervention | Weight loss |
Comparison | ACE inhibitors |
Outcome | Blood pressure |
How do elderly patients in orthopaedic rehabilitation (P) who have been separated from significant pets (I) perceive their motivation to progress (O)?
Patient | Elderly patients in orthopaedic rehabilitation |
Issue | Separated from significant pets |
Outcome | Motivation to progress |
Are children (P) who have parents with high BMI (I) at increased risk of obesity (O)?
Patient | Children |
Issue | Parents with high BMI |
Outcome | Obesity |
Who are the affected population?
Is the population exposed to a condition or illness or to a risk factor?
What are the outcomes or themes?
What are the attitudes (O) of health professionals (P) towards caring for older patients with dementia (E) in an acute setting (P)?
Population | Health professionals in an acute setting |
Exposure | Older patients with dementia |
Outcome | Attitudes |
Does bullying (E) increase the chances of teenagers (P) developing an anxiety related disorder (O)?
Population | Teenagers |
Exposure | Bullying |
Outcome | Anxiety related disorder |
(Adapted from Colorado State University, no date; University of Suffolk, no date)