One of the most important steps in searching the literature is identifying the question you are trying to answer. It is important to take some time before you go into a database to refine your question and identify keywords that you would like to search. 

• PICO is a tool that can help you with this process. It is best suited for clinical, patient-oriented questions.
• For other types of questions, one tip is to think about or identify a perfect article that answers your question. Use that article to identify keywords for your search and then brainstorm synonyms or similar terms. 

Remember to keep track of your question and keywords for future reference--it will help keep you organized when you begin searching. 

PICO helps you: 

• Create a question that will yield more relevant search results.
• Brainstorm keywords to use when searching the databases.
• Keep track of your strategy to prevent confusion when searching the databases.
• Remember your search terms and strategies for future retrieval of results. 

​When to Use PICO?

Foreground questions are best suited to the PICO format. These are clinical questions that focus on the care of a specific patient or population and generally require a search of the primary medical literature. 

Background questions concern general knowledge. These types of questions generally have only 2 parts: A question root (who, what, when, where, how, why) and a disorder, test, treatment, or other aspect of health care.  Often these questions can best be answered by using a textbook or consulting a clinical database, such as UpToDate or DynaMed.

Adapted from CEBM (Oxford)