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PICOT is a technique medical researchers use to develop a clinical research question. It may form part of a formal funding or research proposal, or medical staff may use it to carry out a small-scale experiment. PICOT is an acronym for the five different areas the technique considers – patient population, intervention or issue, comparison with another intervention or issue, outcome and time frame.
According to the "American Journal of Nursing," PICOT provides a consistent method of identifying components of a clinical practice issue. Evidence-based practice is research based on an individual's clinical expertise combined with external clinical research.
Create a general question that you want to study, based on a specific scenario you have experienced as a health care professional or student. The PICOT method uses "foregrounded" questions – questions that are very narrow and relevant to a specific clinical issue. Researchers ask these questions to determine the most effective intervention to improve patient outcomes. Foregrounded questions generally begin with "how" – "how does X affect Y?" The answer should provide useful information for the direct care of patients.
Choose your patient population for the study. Factors to consider include age, gender, health conditions, medication regimen and access.
Determine your intervention – the activity you will undertake for your specific patient population. Since you are basing the research on evidence-based practice, you need to compare two different techniques that your hospital or clinic use, or compare your existing practice with a new idea. The ideas could stem from patient observation and feedback, newly published research findings, the need for cost-saving methods, or activities undertaken at another facility.
Choose your comparison group, people who will not experience the new intervention. If you are testing a medication regimen, your comparison could be the use of a different medication to treat the same problem. Your patient population would receive the new intervention while your comparison group would receive the current standard medication. Usually this group is the status quo, although you could use the PICOT framework to compare two different methods, such as the effect of art therapy versus music therapy. While a comparative group is technically optional in the PICOT framework, it is rare that researchers do not use one.
Predict the possible outcome of the question you are examining. Since you are grounding your research in evidence-based practice, you are using the study to prove your predetermined belief. If you are looking at changing a medication regimen, for example, you may believe the outcome will show that medicine A is more effective than medicine B.
Select the time frame during which you will study the impact of your intervention on the population. The period could be brief – the first 24 hours after surgery – or extended – three months on a new medication. This step is optional because it may not apply in all clinical settings, but using a specific time frame makes it easier for you to analyze your results.
Write out your full proposal. Your facility or funding body may have a specific format to follow. If not, use the PICOT steps to guide your proposal. Follow each PICOT step in order with relevant documentation.
Submit your preliminary question for feedback to experts at Arizona State University, who will give you direction and input before you get started.
Any studies involving patients need to be reviewed by the ethics committee of a hospital or the Institutional Review Board of an academic institution to ensure all patients are properly informed of their rights.
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