Week 3

Research
Proposal
What Makes a Good Research Question: The PICOT Approach
Author

Dr. Samuel Blay Nguah

Published

August 16, 2025

“Wisdom is like a baobab tree; no one individual can embrace it.”

Recap…

Last week, we discovered that your thesis topic doesn’t need to cure cancer, but it should be clear, focused, answerable, and worth reading. This week, we explore the process of developing a research question that evokes happiness, even in the most depressed sceptic.

Introduction

A research question is the backbone of your thesis. Get it wrong, and you’ll limp through the entire process. Get it right, and everything else, from your design to your discussion, flows naturally.

The challenge? Many residents start with vague questions like:

  1. “Does malaria affect children?” (Spoiler: yes, it does.)
  2. “What is the effect of malnutrition?” (On what? Whom? When?)

This is where PICOT comes in. It is not a fancy Italian coffee, but a tool to keep your research question structured, sharp, and answerable. Let us dive into it…

The PICOT Framework Explained

PICOT stands for:
P – Population: Who are you studying?
I – Intervention (or exposure): What’s being applied, tested, or observed?
C – Comparison: What are you comparing it against (if applicable)?
O – Outcome: What measurable effect are you interested in?
T – Time: Over what period?

Together, these elements transform a loose idea into a focused, researchable question. So, let us dissect it!

Population (P)

Be specific. Instead of “children,” say “children under five presenting to the Paediatric Emergency Unit at Korle Bu.”

👉 Bad: “Does asthma affect children?”
👉 Better: “Among school-aged children in Accra…”

Intervention (I)

This could be a treatment, risk factor, diagnostic test, or exposure.

👉 Example: “Use of inhaled corticosteroids” or “exclusive breastfeeding.”

Comparison (C)

Sometimes optional, but always helpful. What’s the alternative? Placebo? No treatment? Standard practice?

👉 Example: “Inhaled corticosteroids vs. short-acting beta agonists alone.”

Outcome (O)

This should be measurable, not vague. Avoid “improved health.” Think: “reduction in asthma exacerbations,” “increase in haemoglobin levels,” or “improved growth velocity.” These are specific and measurable!

Time (T)

Although not always necessary, it adds clarity.
👉 Example: “Over a six-month follow-up.”

Putting It All Together: From Vague to Vivid

Let’s walk through a paediatric example.

  • Vague Question: “Does breastfeeding help babies?”
  • PICOT Question: “Among infants less than 6 months old in Kumasi (P), does exclusive breastfeeding for the first 6 months (I), compared to mixed feeding (C), reduce the incidence of diarrhoeal diseases (O) during infancy (T)?”

See the difference? One belongs in a WhatsApp chat, the other belongs in your thesis protocol.

Why PICOT Matters

  1. Guides Study Design: Your question dictates whether you run a cross-sectional survey, a cohort study, or a clinical trial.
  2. Clarifies Variables: No more mid-thesis panic when you realise you never defined your outcome.
  3. Keeps You Focused: With PICOT, you avoid drifting into irrelevant territory.
  4. Impresses Examiners: A well-structured question signals a well-prepared candidate.

A 2010 review highlighted that structured research questions using PICOT were associated with stronger study design and more transparent reporting (Richardson et al., 1995; Huang et al., 2006).

Summary

The PICOT framework is your thesis compass. It ensures your research question is not only straightforward but also doable. By explicitly defining the who, what, compared to what, expected result, and timeframe, you’ll save yourself headaches later on.

Take-Home Message

Never write a research question that could be answered with a shrug. With PICOT, your question becomes focused, measurable, and worthy of a fellowship thesis.

Next Week on Paediatric Research Insights…

We’ll dissect the “Anatomy of a Good Research Proposal”, think of it as the skeletal system of your thesis, without which your research collapses like a jellyfish.

Until then, may your research questions be sharp, your supervisors impressed, and your comparison groups cooperative. See you next week…bring your skeleton key! 🦴📚

References

  1. Richardson WS, Wilson MC, Nishikawa J, Hayward RS. The well-built clinical question: a key to evidence-based decisions. ACP J Club. 1995 Nov-Dec;123(3):A12–3. PMID: 7582737

  2. Huang X, Lin J, Demner-Fushman D. Evaluation of PICO as a knowledge representation for clinical questions. AMIA Annu Symp Proc. 2006;2006:359-63. PMID: 17238363

  3. Riva JJ, Malik KM, Burnie SJ, Endicott AR, Busse JW. What is your research question? An introduction to the PICOT format for clinicians. J Can Chiropr Assoc. 2012 Sep;56(3):167-71. PMID: 22997465