The first stage of any evidence-based practice process is formulating an answerable question. This forms the foundation for quality searching. A well-formulated question will facilitate the search for evidence and will assist you in determining whether the evidence is relevant to your question.
An answerable question has a format that follows the PICO concept. The acronym translates to:
Other variations of the PICO framework include:
Example of the scenario that the question comes from:
A nurse in aged care home has a lot of patients who get bed sores because they are in bed all, or most of the day. Is there any way to stop them getting bedsores as often? And how can they be treated so that they don't keep getting worse?
The example question laid out using the PICO framework:
Population | aged care residents |
Intervention | |
Comparison | |
Outcome | reduction in incidence and severity of bedsores |
NOTE: You don't have to fill in all of the fields. In this case you can't fill in the intervention, because that is what you are trying to discover. And because there is no intervention, you can't add a comparison intervention either.
Example question reworded as a clinical question for research:
Which interventions reduce the incidence and severity of bed sores in residents of aged care facilities?
Keywords from the example question and possible alternatives:
Words from PICO | Synonyms / Alternatives you could also use |
aged care residents | aged care, nursing home, aged, elderly, geriatric |
bed sores | bedsores, pressure sores, pressure ulcers, decubitus ulcers |
reduction | reduce, reducing, lessen, decrease, minimise, minimize, prevent, improve |
The database search string from the example question
("aged care residents" OR "aged care" OR "nursing home" OR aged OR elderly OR geriatric) AND ("bed sores" OR bedsores OR "pressure sores" OR "pressure ulcers" OR "decubitus ulcers") AND (reduc* OR lessen OR decrease OR minimi?e OR prevent OR improve)
Notes:
Other limits you can apply in a database for this search
This worksheet was adapted from Syrene A. Miller, PICO Worksheet and Search Strategy, National Center for Dental Hygiene Research.