Skip to Main Content


PICO Question

PICO Patient or Problem, Intervention, Comparison Intervention, Outcome

Refining your Topic

Getting Started

Developing Your Topic

Before you start looking for information in databases, it is always a good idea to check out medical dictionaries and encyclopedias to get a general understanding of your topic. Furthermore, take a glance at medical reviews and Wikipedia articles to get an idea of the current issues surrounding your topic. Don't forget to check out the bibliographies in each resource!

Developing Your Research Question

Why should I formulate a structured research question?

  • To point you in a specific direction
  • To help build your literature search strategy
  • To improve your retrieval
  • To give you a way of evaluating answers

Where do questions fit into evidence-based practice?

  1. Formulate the question
  2. Search for the evidence
  3. Appraise the evidence
  4. Apply the results
  5. Evaluate the process

Where do questions come from?

  • Professional practice
  • Professional trends
  • Existing published research
  • Existing theory

What characterizes a good question?

  • well-conceptualized
  • well-developed
  • relevant
  • direct and clear
  • focused
  • includes all components

What does an undeveloped question look like?

  • Is there a benefit in starting a program to prevent elderly clients from falls at home?”

What does a well-formulated question look like?

“Is a fall prevention program more effective than education upon discharge from acute care in decreasing the incidence of falls in elderly clients who live independently at home?” (Lou & Durando, 2008, p. 98)

Research Question Structure

PICO Patient or Problem, Intervention, Comparison Intervention, Outcome
suitability: Good for therapy/treatment or diagnosis type questions.
example: "In an elderly man with a stroke, does admission to a stroke unit decrease the risk of death and dependency?" (CEBM, 2010)
more... Includes examples for therapy, prognosis, diagnosis, and harm scenarios.
PICO + Problem/Person, Client’s setting, Client’s values, Intervention, Comparison, Outcome
suitability: A variation on PICO, so named by Kloda (2010). Emphasizes the client’s setting and values.
example: None provided by authors; implied in the question. (Bennett & Bennett, 2000).
COPES Client Oriented Practical Evidence Search
suitability: For stating client type and problem, what you might do, alternate course of action, what you want to accomplish.
example: "For abused or neglected children placed in foster care by a protective service worker, which risk assessment measure will provide the greatest predictive accuracy to predict reabuse when children are placed back into the homes with their families?" (Gibbs, 2003)
PESICO Person, Environment, Stakeholders, Intervention, Comparison, Outcome
suitability: Augmentative and alternative communication (AAC)
example: "In a 4-year-old child with autism and some vocal imitation skills in need of acquiring linguistic communication who is placed in a segregated preschool (disabled peers) seeking to move to an inclusive preschool (nondisabled peers) and whose preschool teacher and SLP are primarily concerned with communication, whereas his parents wish to enhance his speech as well will the use of certain AAC approaches in comparison to other AAC approaches enhance natural speech production while increasing communication skills?" (Schlosser, Koul, & Costello, 2007)
PIPOH Population, Interventions, Professionals/Patients, Outcome, Health Care Setting  
suitability: Developed specifically for use in the adaptation of oncology guidelines (ie. the health care setting and context in which a guideline is to be implemented).
example: "What is appropriate cervical cancer screening for average risk women seen in primary care?" (ADAPTE Collaboration, 2009)
ECLIPSE Expectation, Client group, Location, Impact, Professionals, Service
suitability: Health policy/management information.
example: "There is a lack of continuity of care in my area for people with head injuries who are discharged from hospital to the community rehabilitation service. I would like to improve the discharge procedure to avoid this problem. The service involves both community health staff and social services. Has anyone else experienced similar problems and how have they overcome them?" (Wildridge & Bell, 2002)


The ADAPTE Collaboration. (2009). The ADAPTE process: resource toolkit for guideline adaptation. Version 2.0. Retrieved from

Bennett, S. & Bennett, J. W. (2000). The process of evidence-based practice in occupational therapy: Informing clinical decisions. Australian Occupational Therapy Journal, 47, 171-180.

Centre for Evidence-Based Medicine. (2010). Formulating answerable clinical questions. Retrieved from

Gibbs, L. (2003).  Evidence based practice for the helping professions: a practical guide with integrated multimedia. Pacific Grove, CA: Wadsworth.

Kloda, L. & Bartlett, J. (2010, June 9). From uncertainty to answerable questions: question negotiation in evidence-based practice.  Paper presented at the annual meeting of the Canadian Health Libraries Association/Association des bibliotheques de la santé du Canada, Kingston, ON. Retrieved from

Lou, J. & Durando, P. (2008). Asking clinical questions and searching for the evidence. In M. Law & J. MacDermid (Eds.), Evidence-based rehabilitation: a guide to practice (pp. 95-117). Thorofare, NJ: Slack.

Schlosser, R., Koul, R., & Costello, J. (2007). Asking well-built questions for evidence-based practice in augmentative and alternative communication.  Journal of Communication Disorders, 40(3), 225-238. doi: 10.1016/j.jcomdis.2006.06.008

Wildridge, V., & Bell, L. (2002). How CLIP became ECLIPSE: a mnemonic to assist in searching for health policy/management information. Health Information & Libraries Journal, 19, 113-115. doi: 10.1046/j.1471-1842.2002.00378.x