Introduction to the PICOS
approach
PICOS approach
• Formulating relevant and precise questions that
can be answered in a systematic review can be
complex and time consuming
• PICOS advocated in the PRISMA Statement 1 for
reporting systematic reviews and meta-analyses of
interventions to:
•
•
•
•
report explicitly the question addressed
specify the eligibility criteria
specify the data to be extracted from each study
report data extracted from each study
PICOS approach
• PICOS is a structured approach for framing questions
involving five components 2
• Acronym PICOS: Each letter refers to a component:
P:
the patient population or the
disease being addressed,
I:
the interventions or exposure,
C:
the comparator group,
O:
the outcome or endpoint, and
S:
the study design chosen
Example 1 – Grec et al. (2013) 3
Example 1 – Grec et al. (2013) 3
P: subjects with Class II malocclusion
I:
intraoral distalizers with conventional
anchorage
C: intraoral distalizers with skeletal
anchorage
O: efficiency in the correction of Class II
malocclusion
S: (not defined)
Example 2 – Fleming et al. (2013) 4
Example 2 – Fleming et al. (2013) 4
P: patients with complete arch, fixed or
bonded orthodontic appliances
I:
LED or plasma arc light
C: conventional halogen lamps
O: initial bond failure
S: randomized and controlled clinical
trials (split-mouth designs included)
Example 3 – Yang et al. (2014) 5
Example 3 – Yang et al. (2014) 5
P: patients aged 5 to 15 years,
diagnosed as having an Angle Class
III malocclusion in the growth and
development period
I:
Fränkel-3 appliance
C: no treatment
O: changes in cephalometric
measurements
S: randomized controlled clinical trials,
clinical controlled trials, and cohort
studies
References
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2.
3.
4.
5.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ,
Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses
of studies that evaluate health care interventions: explanation and elaboration. PLoS Med
2009;6:e1000100.
O’Connor D, Green S, Higgins JPT (2008) Chapter 5: Defining the review question and
developing criteria for including studies. In: Higgins JPT, Green S, eds. Cochrane handbook for
systematic reviews of interventions version 5.0.0 [updated February 2008]. The Cochrane
Collaboration, Available: http:// www.cochrane-handbook.org/. Accessed 15 December 2014.
Grec RH, Janson G, Branco NC, Moura-Grec PG, Patel MP, Castanha Henriques JF. Intraoral
distalizer effects with conventional and skeletal anchorage: a meta-analysis. Am J Orthod
Dentofacial Orthop 2013;143:602-15.
Fleming PS, Eliades T, Katsaros C, Pandis N. Curing lights for orthodontic bonding: a systematic
review and meta-analysis. Am J Orthod Dentofacial Orthop 2013;143:S92-103.
Yang X, Li C, Bai D, Su N, Chen T, Xu Y, Han X. Treatment effectiveness of Fränkel function
regulator on the Class III malocclusion: a systematic review and meta-analysis. Am J Orthod
Dentofacial Orthop 2014;146:143-54.