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!
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Image: PressBooks
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The process for developing a research question There are many ways of framing questions depending on the topic, discipline, or type of questions. Try Elicit to generate a few options for your initial research topic and narrow it down to a specific population, geographical location, disease, etc. You may explore a similar tool, LitSense to identify additional search terms. 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.
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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 |
| PerSPECTiF |
Perspective |
Booth, A., Noyes, J., Flemming, K., Moore, G., Tunçalp, Ö., & Shakibazadeh, E. (2019). Formulating questions to explore complex interventions within qualitative evidence synthesis. BMJ Global Health, 4(Suppl 1). | Qualitative research |
| PESICO | Person Environments Stakeholders Intervention Comparison Outcome |
Schlosser, R. W., & O'Neil-Pirozzi, T. (2006). Problem formulation in evidence-based practice and systematic reviews. Contemporary 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 decisions. ACP journal club, 123(3), A12-A12. | Clinical medicine |
| PICO+ |
Patient +context, patient values, and preferences |
Bennett, S., & Bennett, J. W. (2000). The process of evidence‐based practice in occupational therapy: Informing clinical decisions. Australian Occupational Therapy Journal, 47(4), 171-180. | Occupational therapy |
| PICOC |
Patient Context |
Petticrew, M., & Roberts, H. (2006). Systematic reviews in the social sciences: A practical guide. Malden, MA: Blackwell Publishers. | Social Sciences |
| PICOS |
Patient 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 Time |
Richardson, W. S., Wilson, M. C., Nishikawa, J., & Hayward, R. S. (1995). The well-built clinical question: A key to evidence-based decisions. ACP 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 ----- 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 practice. Library 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.
