Clinical questions in the PICO(T)

Week 2 Case Study for Threaded Discussion
CASE STUDY: John is a 56-year-old male who was initially diagnosed six months ago with
Heart Failure. He was treated via a three-day stay in the hospital and sent home with a
drug regime and since then has been seen in the ER two times and now re-hospitalized with
shortness of breath, pedal edema, and weight gain. He does not understand why the
medications are not working. He cannot miss any more days at work or he will lose his job
and medical insurance for him and his family. His wife is a stay at home mom for their
three boys.
John is a construction worker and does take his medications as directed but continues to
eat what he wants.
He states he cannot exercise because he works six days a week and is just too tired when he
gets home. He is always tired, up all night going to the bathroom, and is extremely worried
about his health issues and the future. His wife Kathy is also very worried because she is a
stay at home mom and has not worked since the birth of their first child who is 16 years
old. During this hospital stay, another cardiac catheterization reveals that the ejection
fraction of his heart is only 40. The doctor has told him he needs to change his lifestyle,
continue with his meds, and monitor his vital signs at home.
John’s wife, Kathy, is 40 years old and finds herself overwhelmed with the diagnosis and is
worried that she may have to go back to work if John is not able to continue working. She
wants to know what she can do to help John. She will do anything but she is not sure what
will help John. The nurse came in and handed her a bunch of papers about diet and
exercise and said a home health nurse would set him up for home monitoring.

  1. Formulate searchable, clinical questions in the PICO(T) format using the material in this
    case study.
  2. There are several potential questions that could be asked, but you only need to identify
    *Determine if the focus of each question is assessment, etiology, treatment, or

Heart Failure

The PICOT question format is a useful formula that provides a consistent way of
developing answerable and researchable questions. It is a strategy that most people use to ease
the process of digging and evaluating evidence. The acronym stands for the population,
intervention, comparison, outcome, and time. In most cases, it is used to answer questions that

fall in various types including therapy, prevention, diagnosis, etiology and prognosis (Lansing
Community College Library, 2014). This paper formulates two questions using the PICOT
formula and incorporating the facts in the case study provided.
Question one
Does a three day hospitalization and drug administration (I) in male aged above 50 years with
heart failure (P) lead to reduced symptoms of heart problem (I) compared to body exercises ( C)
within the first month of initial medication (T).
Question two
Are children (P) that have parents suffering from heart complications (I) at increased chances of
suffering from the same (O) compared to children (P) without parents that suffer from heart
failure (C) during the ages of five and 16 years?
The first question is a prognosis type of question because it aims at creating understanding
through predictions. It, therefore, seeks more clarification on whether a patient that suffers from
heart failure can recover in three days through the administration of some drugs.
The second question is an etiology question. The question aims at finding the cause of the heart
problem. There might be many causes of heart failure in different patients but in these
circumstances, the focus is on whether the disease relates to genetics. Therefore, does it mean
that the diagnosis of a parent with a heart problem increase the possibility of a child suffering
from the same?
Therefore, the PICOT acronym is effective in providing guidance and understanding various
aspects concerning different medical complications, their causes, treatment, diagnosis, and even
prevention strategies.



Lansing Community College Library. (2014). What is PICOT?