Before you develop your research topic or question, you'll need to do some background research first.
Some good places to find background information:
Try the library databases below to explore your topic. When you're ready, move on to refining your topic.
You can also check out the Evidence-Based Practice Guide for more in-depth research assignments, such as PICO(T).
Now that you've done some background research, it's time to narrow your topic. Remember: the shorter your final paper, the narrower your topic needs to be. Here are some suggestions for narrowing and defining your topic:
Describe and develop your topic in some detail. Try filling in the blanks in the following sentence, as much as you can:
I want to research ____(what/who)____
and ____(what/who)____
in ____(where)____
during ____(when)____
because ____(why)____.
PICO is a method that can help take you from a patient care situation/scenario to developing a foreground question, to help you focus on what exactly your information need is. Once you have these elements, you can move to converting them to search terms for your literature search.
P refers to the patient or population or problem.
Describe either the patient's chief complaint or generalize the patient's condition to a larger population.
I refers to the intervention or indicator.
What do you plan to do for that patient? This may include the use of a specific diagnostic test, treatment, adjunctive therapy, medication or the recommendation to the patient to use a product or procedure.
C refers to the comparison or benchmark against which the intervention is measured.
This is the main alternative you are considering. It should be specific and limited to one alternative choice in order to facilitate an effective computerized search. The Comparison is an optional component in the PICO question. You may look at the Intervention without exploring alternatives or, in some cases, there may not be an alternative.
O refers to the outcome or the anticipated result of the intervention.
This specifies the result(s) of what you plan to accomplish, improve or affect and should be measurable. When the intervention is a diagnosis the outcome may be about the reliability or validity of the test. With prognosis or treatment as the intervention, the outcome might be some specific morbidity. Outcomes may be worded in terms of relieving or eliminating specific symptoms, improving quality of life or maintaining or enhancing function, lowering costs, etc.
T refers to the timeframe for data collection or time to outcome. This element is optional.
Fill in the blanks with information from your clinical scenario:
THERAPY
In_______________, what is the effect of ________________on _______________ compared with _________________?
ETIOLOGY
Are ______________ who have _______________ at ______________ risk for/of ____________ compared with _____________ with/without ______________?
DIAGNOSIS OR DIAGNOSTIC TEST
Are (Is) ________________ more accurate in diagnosing _______________ compared with ____________?
PREVENTION
For ___________ does the use of _________________ reduce the future risk of ____________ compared with ______________?
PROGNOSIS
Does ____________ influence ______________ in patients who have _____________?
MEANING
How do _______________ diagnosed with _______________ perceive __________________?
Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.
Here is an example of a scenario/patient situation expressed in PICO and the elements that might be identified:
Systemic steroids, such as prednisone, slow bone growth. Children with chronic asthma are often prescribed inhaled steroids or corticosteroids. Do these drugs have any impact on growth before adolescence?
P: preadolescents with asthma
I: inhaled corticosteroids
C: treatment without corticosteroids
O: growth at predicted rate
In preadolescents with asthma will inhaled corticosteroids suppress normal growth (as compared to treatment without corticosteroids)?
You try it:
Your patient is a 73 year old female in good health with normal cholesterol levels and no chronic diseases. However she has started to notice that she is forgetting things more often and having problems with some every-day tasks like balancing her checkbook; she’s fearful that she might be “getting Alzheimer’s Disease.” She mentions that her neighbor told her that Lipitor is supposed to help with the symptoms or maybe even prevent Alzheimer’s disease. She wants your advice. Would this help?
P:
I:
C:
O:
This template can help you put it all together
In ______________________________________________
P component
how does ________________________________________
I component
compared with ____________________________________
C component
*affect ___________________________________________
O component
*This verb will vary depending on your outcome; it might be a term such as lower,decrease, reduce, increase, relieve, eliminate, prevent, etc.
Not everyone will "see" the same question(s) in the same patient scenario. Some possible clinical questions from this situation: