Copyright © 2020 pubrica. All rights reserved 1

What are the PICO Elements in Systematic Review

Dr. Nancy Agens, Head,

Technical Operations, Pubrica

sales@pubrica.com

In Brief

The PICO framework is used in evidence-

based practice and especially in evidence-

based medicine to formulate a clinical or

healthcare related question. In a

, the PICO framework is systematic review

also used to develop literature search

strategies to ensure the comprehensive

and bias-free searches. The Cochrane

Handbook for Systematic Reviews of

Interventions mentioned using the PICO

framework as a model for developing a

review question, thus ensures that the

relevant components of the question are

well defined.

I. INTRODUCTION

is a method A systematic review

supporting evidence-based practices and

healthcare decisions primarily through

quantitative approach whereby a complete

search is conducted in attempting to

identify all the related publications which

are integrated and assimilated through

statistical analysis. The crucial factor for a

systematic review is a comprehensive

search process as it can be viewed as

preventing the and thus risk of bias

providing quality representation of

available research. However, current

research investigation process mainly

focuses on different methods to ensure the

comprehensive and bias-free searches for

. Because quantitative systematic reviews

of time consumption and resources

requirement in completing a systematic

literature search, multiple efforts have

been made to study the sensitivity of

searches, and thus it reduces the amount of

time spent reviewing irrelevant articles

which are of no use. Through devising a

, a search tool has been search strategy

used in organizing framework to list terms

in the search questions by the main

concepts and such frameworks will also be

very helpful for teams doing a systematic

without an experienced review

information specialist. The PICO

focuses on the Population, framework

Intervention, Comparison and Outcomes

and it is a commonly used tool quantitative

systematic review to identify different

components of clinical evidence for a

systematic review, and the Cochrane

recognizes it. Collaboration

Fig 1. PICO

Practitioners of Evidence-Based Practice

(EBP) often use a specialized framework,

called PICO, to form the question and

facilitate the literature search. A systematic

review question typically focused on

narrow parameters and usually fitted into

the . PICO question format

P – Patient | Population

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Most important characteristics of

patients. Examples: Gender, age, and

disease or condition

I – Intervention or exposure

Main intervention. Examples: Drug

treatment, diagnostic and screening test

C – Comparison or control

Main alternative. Examples:

Standard therapy, placebo, no treatment,

and a gold standard

O – Outcome

What you are trying to accomplish,

improve, measure, affect. Examples:

Reduced mortality or morbidity, and

improved memory

PICO can be used along with the variant

such as PICOS (S-Study design), PICOC

(C-Context), and PICOT (T-timeframe).

Table 1: Search Strategy

The PICO model was developed to help

structure a well-built and clinical question

enable a of relevant literature search

citations. Since its introduction, it has

played an essential role as a

conceptualizing model for evidence-based

medicine. The PICO framework will also

help in reducing the time and retrieving

related documents, thus ensures bias-free

, and it also quality systematic review

helps to determine the transparency of

evidence synthesis results and findings.

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REFERENCE

1. Wilson, MC, Richardson, WS, Nishikawa, J &

Hayward, RS 1995, 'The well-built clinical

question: A key to evidence-based decisions', ACP

Journal Club, vol. 123, no. 3, pp. A12-A12.

2. The Systematic Review: An Overview American

Journal of Nursing: March 2014 - Volume 114 -

Issue 3 - p 53-58.

DOI: 10.1097/01.NAJ.0000444496.24228.2c

3. Mette Brandt Eriksen, The impact of patient,

intervention, comparison, outcome (PICO) as a

search strategy tool on literature search quality: a

systematic review, J Med Libr Assoc. 2018 Oct;

106(4): 420–43.

DOI: 10.5195/jmla.2018.345

4. Alex Pollock and Eivind Berge, How to do a

systematic review, International Journal of Stroke

2018, vol. 13(2) 138–156.

DOI: 10.1177/1747493017743796