PICO process

The PICO process (or framework) is a mnemonic used in evidence-based practice (and specifically evidence-based medicine) to frame and answer a clinical or health care related question,[1] though it is also argued that PICO "can be used universally for every scientific endeavour in any discipline with all study designs".[2] The PICO framework is also used to develop literature search strategies, for instance in systematic reviews.[3]

The PICO acronym has come to stand for:[4][5]

  • P – Patient, problem or population
  • I – Intervention
  • C – Comparison, control or comparator[6]
  • O – Outcome(s) (e.g. pain, fatigue, nausea, infections, death)

An application that covers clinical questions about interventions, as well as exposures, risk/ prognostic factors, and test accuracy, is:[7][8]

  • P – Patient, problem or population
  • I – Investigated condition (e.g. intervention, exposure, risk/ prognostic factor, or test result)
  • C – Comparison condition (e.g. intervention, exposure, risk/ prognostic factor, or test result respectively)
  • O – Outcome(s) (e.g. symptom, syndrome, or disease of interest)

Alternatives such as SPICE and PECO (among many others) can also be used. Some authors suggest adding T and S, as follows:

  1. ^ Huang X, Lin J, Demner-Fushman D (2006). "Evaluation of PICO as a knowledge representation for clinical questions" (PDF). AMIA Annu Symp Proc. 2006: 359–63. PMC 1839740. PMID 17238363.
  2. ^ Nishikawa-Pacher, Andreas (2022). "Research Questions with PICO: A Universal Mnemonic". Publications. 10 (3): 21. doi:10.3390/publications10030021. eISSN 2304-6775.
  3. ^ Schardt C, Adams MB, Owens T, Keitz S, Fontelo P (2007). "Utilization of the PICO framework to improve searching PubMed for clinical questions". BMC Med Inform Decis Mak. 7: 16. doi:10.1186/1472-6947-7-16. PMC 1904193. PMID 17573961.
  4. ^ "Asking a Good Question (PICO)". 17 November 2004. Archived from the original on 2011-02-26. Retrieved 2010-05-18.
  5. ^ Richardson, WS (1995). "The well-built clinical question: a key to evidence based-decisions". ACP Journal Club. 123, 3 (3): A12–A13. doi:10.7326/ACPJC-1995-123-3-A12.
  6. ^ "Systematic Review Methods". Chapter 2. Systematic Review Methods -- AHRQ Technical Reviews and Summaries -- NCBI Bookshelf. Agency for Healthcare Research and Quality (US). March 2009. Retrieved 2010-05-18.
  7. ^ Richardson, WS (1995). "The well-built clinical question: a key to evidence based-decisions". ACP Journal Club. 123, 3 (3): A12–A13. doi:10.7326/ACPJC-1995-123-3-A12.
  8. ^ Luijendijk HJ (2021). "How to PICO questions about medical tests". BMJ Evidence-Based Medicine. 26 (4): 155–157. doi:10.1136/bmjebm-2021-111676. PMC 8311106. PMID 33789913.