PICOT Research Question

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Top Contributors - Kapil Narale and Rishika Babburu  

Introduction

The PICOT research question is widely used throughout the medical field, whether you're a Clinician, Physician, or Student. Creating a detailed and purposeful research question is one of the first steps into investigating different sources of knowledge, and conducting one's own evidence based research to learn about a topic or condition, and further their knowledge. This research is evidence based as it involves studies or reviews conducted by colleagues in the same or related disciplines. In turn, creating studies, and being able to conduct the research for further knowledge is a shared initiative between clinicians and researchers.

In exclaiming the important of mapping out a research question, it was noted by David L. Sackett, Officer of the Order of Canada and the founding Chair of Canada’s first Department of Clinical Epidemiology & Biostatistics at McMaster University, that: “one-third of a trial’s time between the germ of your idea and its publication in the New England Journal of Medicine should be spent fighting about the research question”.

P

P represents Population - this would indicate the type of person or population of people that you want to research about. Here, you can note tier characteristics, perhaps any health conditions that might be present, any health goals, or any other qualities.

I

I represents Intervention - this would be the treatment, conditions, or changing factor present in the question you are creating.

C

C represents Comparison - this would be the group you want to compare to, generally the control group, who receives no treatment, a general standard treatment, or a 'gold-standard' treatment.

O

O represents Outcome - this is the result or outcome that you would like measured in your research question. This would indicate the result of the intervention in your question.

T

T, is an optional component of PICOT which represents Time - the period, or duration of effect, that is a part of your research question.

Creating a PICOT question

An example of a PICOT question developed from the Canadian Chiropractic Association, regarding neck pain is as follows,

"In adults with chronic neck pain, what is the minimum dose of manipulation necessary to produce a clinically important improvement in neck pain compared to supervised exercise at 6 weeks?"

This was put together using the individual PICOT factors outlined,

• (P) – Population: Adults 18 to 60 years of age, with a clinical diagnosis of chronic mechanical neck pain.
• (I) – Intervention: Subjects randomized to have manipulation would receive standard rotary or lateral break diversified technique once, twice, or three times per week over 2, 4, or 6 weeks. They will also receive the same exercise program assigned to the control group, to eliminate a second variable in the study.
• (C) – Comparison: A standardized supervised exercise program will be used as an active control group. All subjects will perform a standardized exercise program at each session during the 6 week period. The non-specific effects due to attending a clinic, will be minimized.
• (O) – Outcome: Changes in neck pain, measured using the 100mm VAS for pain.
• (T) – Time: The outcome would be measured weekly for 6 weeks.

Considerations

Although guidelines may be set by Professional Standards, Institutions, or Workplaces, there are some important considerations when designing a PICOT research question.

The detail of the literature search, including the breadth and quality of such detail would need to be considered.

The targeted study design would need to be chosen.

The exact patient population of the literature search will need to be chosen and defined.

Each of the factors of PICOT will need to be clearly chosen and defined, to create the desired research question.

Implications

It is interesting to note that there are some implications to using the PICOT research question method, of creating a study, more than researching to gather information.

• Many of these research questions are costly, time-constraining, and difficult to conduct, especially with anRCT study design.
• Not every question that Clinicians would like answered are feasible with such a research methodology.