PICOTT is a mnemonic used to describe elements of a good clinical foreground question to be directly relevant to the patient or problem at hand. The PICOTT model is used in evidence-based practice to assist in formulation of the search strategy by identifying the key concepts and synonyms that is searchable in the article that can answer the question. PICOTT is used in professional practice, and is strongly advocated as a tool in the NHS. You may have heard of similar methods of developing answerable clinical questions, such as SPICE, but we mainly refer to PICOTT.
PICO or PICOTT:
PATIENT OR PROBLEM
How would you describe a group of patients similar to yours? What are the most important characteristics of the patient?
INTERVENTION, EXPOSURE, PROGNOSTIC FACTOR
What main intervention are you considering? What do you want to do with this patient?
COMPARISON
What is the main alternative being considered, if any?
OUTCOME
What are you trying to accomplish, measure, improve or affect?
Type of Question
Therapy / Diagnosis / Harm / Prognosis / Prevention
Type of Study
Systematic review / RCT / cohort study / case control
Knowing the Type of Clinical Question will help you determine the best type of study design. The table* below demonstrates the types of studies generally recommended to answer particular types of clinical questions.
In _______________(P), what is the effect of _________(I) on _________(O) compared with _________(C) within _______________(T)
Based on Melnyk B., & Fineout-Overholt E. (2010). Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins.
Are _________ (P), what is the effect of _________(I) on ____________(O) compared with _____________(C) within ___________(T)?
Based on Melnyk B., & Fineout-Overholt E. (2010). Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins.
Are (is)_______________ (I) more accurate in diagnosing _______________ (P) compared with _______________ (C)for_______________(O)?
Based on Melnyk B., & Fineout-Overholt E. (2010). Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins.
For _______________(P) does the use of _______________ (I) reduce the future risk of _______________ (O) compared with _______________(C)?
Based on Melnyk B., & Fineout-Overholt E. (2010). Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins.
Does _______________ (I) influence _______________(O) in patients who have _______________ (P) over _______________ (T)?
Based on Melnyk B., & Fineout-Overholt E. (2010). Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins.
How do _______________(P) diagnosed with _______________(I) perceive_______________ (O) during _______________ (T)?
Based on Melnyk B., & Fineout-Overholt E. (2010). Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins.