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What are the PICO Elements in Systematic Review
Dr. Nancy Agens, Head,
Technical Operations, Pubrica
[email protected]
In Brief
The PICO framework is used in evidencebased practice and especially in evidencebased medicine to formulate a clinical or
healthcare related question. In a
systematic review, the PICO framework is
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.
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
review
without
an
experienced
information specialist. The PICO
framework focuses on the Population,
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
Collaboration recognizes it.
I. INTRODUCTION
A systematic review is a method
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 risk of bias and thus
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
quantitative systematic reviews. Because
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
search strategy, a search tool has been
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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
1
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
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).
Main
alternative.
Examples:
Standard therapy, placebo, no treatment,
and a gold standard
Table 1: Search Strategy
The PICO model was developed to help
structure a well-built clinical question and
enable a literature search of relevant
citations. Since its introduction, it has
played an essential
role as a
Copyright © 2020 pubrica. All rights reserved
conceptualizing model for evidence-based
medicine. The PICO framework will also
help in reducing the time and retrieving
related documents, thus ensures bias-free
quality systematic review, and it also
helps to determine the transparency of
evidence synthesis results and findings.
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REFERENCE
1.
2.
3.
4.
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.
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
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
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
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