PICO process

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The PICO process (or framework) is a mnemonic used in evidence based practice (and specifically Evidence Based Medicine) to frame and answer a clinical or health care related question.[1] The PICO framework is also used to develop literature search strategies, for instance in systematic reviews.[2] The PICO acronym stands for[3][4]

  • P – Patient, Problem or Population
  • I – Intervention
  • C – Comparison, control or comparator[5]
  • O – Outcome(s) (e.g. pain, fatigue, nausea, infections, death)

Alternatives such as SPICE and PECO (among many others) can also be used. Some authors suggest adding T and S, as follows:


Clinical question: "In children with headache, is paracetamol more effective than placebo against pain?"

  • Population = Children with headaches; keywords = children + headache
  • Intervention = Paracetamol; keyword = paracetamol
  • Compared with = Placebo; keyword = placebo
  • Outcome of interest = Pain; keyword = pain

Pubmed (health research database) search strategy: children headache paracetamol placebo pain


  1. ^ Huang X, Lin J, Demner-Fushman D (2006). "Evaluation of PICO as a knowledge representation for clinical questions" (PDF). AMIA Annu Symp Proc: 359–63. PMC 1839740. PMID 17238363.
  2. ^ Schardt C, Adams MB, Owens T, Keitz S, Fontelo P (2007). "Utilization of the PICO framework to improve searching PubMed for clinical questions". BMC Med Inform Decis Mak. 7: 16. doi:10.1186/1472-6947-7-16. PMC 1904193. PMID 17573961.
  3. ^ "Asking a Good Question (PICO)". 17 November 2004. Archived from the original on 2011-02-26. Retrieved 2010-05-18.
  4. ^ Richardson, WS (1995). "The well-built clinical question: a key to evidence based-decisions". ACP Journal Club. 123, 3: A12–A13.
  5. ^ "Chapter 2. Systematic Review Methods -- AHRQ Technical Reviews and Summaries -- NCBI Bookshelf". Retrieved 2010-05-18.