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“You can tell whether a man is clever by his answers. You can tell whether a man is wise by his questions.”

–Naguib Mahfouz

Most disciplines in health-related fields find that using a consistent method for structuring clinical questions is an important component of evidence-based practice (EBP), whether the use is to guide clinical or research inquiries. In the early 1990s, PICO (P = patient/problem/population, I = intervention, C = comparison, O = outcome) was developed as a means of focusing a broad need for clinical information to a narrower and more focused query (Oxman, Sackett, & Guyatt, 1993; Richardson, Wilson, Nishikawa, & Hayward, 1995). Adaptations to PICO have appeared in the literature to customize it for different needs (see Table 2.1). For example, in this book we use the P to mean patient population/problem/pilot area, and the term PICOT employs the same elements as PICO with the addition of T = time frame, which can be useful when creating a timeline for short-term projects. Using PICO to identify components of a purpose statement helps articulate important points to include and guides formulation of a focused and clear purpose statement (Rice, 2010; Rios, Ye, & Thabane, 2010).

Table 2.1Clinical Questions and Domains

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