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Using PICO for Scientific Research

The PICO method of search was initially developed for use in health science research. However, the fundamental strategies of the PICO method can be utilized effectively for scientific research in many disciplines. PICO helps a researcher identify the key terms that should be included in a search. PICO is an acronym that stands for:

P - Patient: what is the population that are you interested in? Think of this as the subject of your research.

I - Intervention: what is the exposure or intervention that you are interested in? Think of this as the independent variable in an experiment. 

C - Comparison: what is the comparison to the current intervention? What other factors could be considered as an alternative to the main intervention? For many types of research, this step can be ommitted.

O - Outcome: what are you hoping to measure or improve? Think of this as the dependent variable in an experiment.

While this process may seem formulaic, it helps identify terms that should be included in your search strategy. By doing this BEFORE you attempt to do a search, you can ensure that you will not waste your time looking at search results that are not relevant to your research.

For additional resources on PICO, please see the links below. Need more help applying PICO or creating a search strategy? Contact a librarian!

Search Strategy Frameworks

A sequence of а funnel, a circle full of questions and a single big question mark. A sign above this sequence says, "Narrow topic, Think of questions, and Focus question."

Image: PressBooks 

 

 

The process for developing a research question

There are many ways of framing questions depending on the topic, discipline, or type of questions.

Several frameworks are listed in the table below.

Source:

Foster, M. & Jewell, S. (Eds). (2017). Assembling the pieces of a systematic review: Guide for librarians. Medical Library Association, Lanham: Rowman & Littlefield. p. 38, Table 3.

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Watch the 4 min. video on how to frame a research question with PICO.

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Frameworks for research questions

Framework Stands for Source Discipline/type of question
BeHEMoTh Be: behavior of interest
H: health contest (service/policy/intervention)
E: exclusions
MoTh: models or theories
Booth, A., & Carroll, C. (2015). Systematic searching for theory to inform systematic reviews: Is it feasible? Is it desirable? Health Information and Libraries Journal, 32(3), 220–235. https://doi.org/10.1111/hir.12108
 
Questions about theories
CHIP Context
How
Issues
Population
Shaw, R. (2010). Conducting literature reviews. In M. A. Forester (Ed.), Doing Qualitative Research in Psychology: A Practical Guide (pp. 39-52). London, Sage.
 
Psychology, qualitative
CIMO Context
Intervention
Mechanisms
Outcomes
Denyer, D., & Tranfield, D. (2009). Producing a systematic review. In D. A. Buchanan & A. Bryman (Eds.), The Sage handbook of organizational research methods (pp. 671-689). Thousand Oaks, CA: Sage Publications Ltd.
Management, business, administration
CLIP Client group
Location of provided service
Improvement/Information/Innovation
Professionals (who provides the service?)
Wildridge, V., & Bell, L. (2002). How CLIP became ECLIPSE: A mnemonic to assist in searching for health policy/management information. Health Information & Libraries Journal, 19(2), 113–115. https://doi.org/10.1046/j.1471-1842.2002.00378.x
 
Librarianship, management, policy
COPES Client-Oriented
Practical
Evidence
Search
Gibbs, L. (2003). Evidence-based practice for the helping professions: A practical guide with integrated multimedia. Pacific Grove, CA: Brooks/Cole-Thomson Learning. Social work, health care, nursing
ECLIPSE Expectation
Client
Location
Impact
Professionals
Service
Wildridge, V., & Bell, L. (2002). How CLIP became ECLIPSE: A mnemonic to assist in searching for health policy/management information. Health Information & Libraries Journal, 19(2), 113–115. https://doi.org/10.1046/j.1471-1842.2002.00378.x Management, services, policy, social care
PEO Population
Exposure
Outcome
Khan, K. S., Kunz, R., Kleijnen, J., & Antes, G. (2003). Systematic reviews to support evidence-based medicine: How to review and apply findings of healthcare research. London: Royal Society of Medicine Press. Qualitative
PECODR Patient/population/problem
Exposure
Comparison
Outcome
Duration
Results
Dawes, M., Pluye, P., Shea, L., Grad, R., Greenberg, A., & Nie, J.-Y. (2007). The identification of clinically important elements within medical journal abstracts: Patient_Population_Problem, Exposure_Intervention, Comparison, Outcome, Duration and Results (PECODR). Journal of Innovation in Health Informatics, 15(1), 9–16.
 
Medicine
PESICO Person
Environments
Stakeholders
Intervention
Comparison
Outcome
Schlosser, R. W., & O'Neil-Pirozzi, T. (2006). Problem formulation in evidence-based practice and systematic reviewsContemporary Issues in Communication Sciences and Disorders, 33, 5-10. Augmentative and alternative communication
PICO Patient
Intervention
Comparison
Outcome
Richardson, W. S., Wilson, M. C., Nishikawa, J., & Hayward, R. S. (1995). The well-built clinical question: A key to evidence-based decisionsACP journal club, 123(3), A12-A12. Clinical medicine
PICO+

Patient
Intervention
Comparison
Outcome

+context, patient values, and preferences

Bennett, S., & Bennett, J. W. (2000). The process of evidence‐based practice in occupational therapy: Informing clinical decisionsAustralian Occupational Therapy Journal, 47(4), 171-180. Occupational therapy
PICOC

Patient
Intervention
Comparison
Outcome

Context

Petticrew, M., & Roberts, H. (2006). Systematic reviews in the social sciences: A practical guide. Malden, MA: Blackwell Publishers.  Social Sciences
PICOS

Patient
Intervention
Comparison
Outcome

Study Type

Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Prisma Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS medicine, 6(7), e1000097. Medicine
PICOT

Patient
Intervention
Comparison
Outcome

Time

Richardson, W. S., Wilson, M. C., Nishikawa, J., & Hayward, R. S. (1995). The well-built clinical question: A key to evidence-based decisionsACP journal club, 123(3), A12-A12. Education, health care
PICO specific to diagnostic tests Patient/participants/population
Index tests
Comparator/reference tests
Outcome
Kim, K. W., Lee, J., Choi, S. H., Huh, J., & Park, S. H. (2015). Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: A practical review for clinical researchers - Part I. General guidance and tips. Korean Journal of Radiology, 16(6), 1175-1187. Diagnostic questions
PIPOH Population
Intervention
Professionals
Outcomes
Health care setting/context
ADAPTE Collaboration. (2009). The ADAPTE Process: Resource Toolkit for guideline adaptation. Version 2.0. Available from http://www.g-i-n.net Screening
ProPheT Problem
Phenomenon of interest
Time

Booth, A., Noyes, J., Flemming, K., Gerhardus, A., Wahlster, P., van der Wilt, G. J., ... & Rehfuess, E. (2016). Guidance on choosing qualitative evidence synthesis methods for use in health technology assessments of complex interventions. [Technical Report]. https://doi.org/10.13140/RG.2.1.2318.0562

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Booth, A., Sutton, A., & Papaioannou, D. (2016). Systematic approaches to a successful literature review (2. ed.). London: Sage.

Social sciences, qualitative, library science
SPICE Setting
Perspective
Interest
Comparison
Evaluation
Booth, A. (2006). Clear and present questions: formulating questions for evidence based practiceLibrary Hi Tech, 24(3), 355-368. Library and information sciences
SPIDER Sample
Phenomenon of interest
Design
Evaluation
Research type
Cooke, A., Smith, D., & Booth, A. (2012). Beyond PICO: The SPIDER tool for qualitative evidence synthesis. Qualitative health research, 22(10), 1435-1443. Health, qualitative research
WWH Who
What
How

What was done? (intervention, exposure, policy, phenomenon)

How does the what affect the who?

 

Further reading:

Methley, A. M., Campbell, S., Chew-Graham, C., McNally, R., & Cheraghi-Sohi, S. (2014). PICO, PICOS and SPIDER: A comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Services Research, 14(1), 579.