Biostatistics & Research · patient case question
In a PICO question, what does the 'P' represent?
Patient case: Evidence, and a Patient Irradiated Ten Years Ago
Patient: 66-year-old male
Chief Complaint: Two non-restorable mandibular molars requiring extraction.
Background: Squamous cell carcinoma of the floor of mouth treated ten years ago with surgery and RADIOTHERAPY to the head and neck, total dose approximately 66 Gy. Currently disease-free. His new dentist is reviewing the published evidence on managing extractions in irradiated bone.
Medications: None
Vital Signs: BP 132/80 mmHg · HR 74 bpm · RR 16 · T 98.4°F
Findings: Teeth #30 and #31 are non-restorable with periapical radiolucencies. Overlying mucosa is intact. Xerostomia with rampant cervical caries on the remaining dentition. Trismus with maximum opening 32 mm.
Show answer and explanation
Correct answer: D. Population or patient problem
- A. Probability is not a PICO element.
- B. Prognosis is one of the question TYPES a PICO can address, alongside therapy, diagnosis, aetiology and harm — but it is not what the P stands for.
- C. Prevalence is an epidemiological measure, not a PICO element.
- D. CORRECT. P is the POPULATION, patient or problem — who the question is about. The full framework is P (population or problem), I (intervention), C (comparison), O (outcome). A well-formed PICO turns a vague clinical question into a searchable one. Applied here: in irradiated patients requiring mandibular extraction (P), does hyperbaric oxygen (I) compared with antibiotic prophylaxis alone (C) reduce the incidence of osteoradionecrosis (O)?
Note: Some versions add a T for Time or Type of study, giving PICOT. The value of the framework is that it forces you to specify the comparison, which is the element most often left vague.
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