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The PICO Framework for Framing Systematic

Review Research Questions

Dr. Nancy Agnes, Head, Technical Operations, Pubrica, [email protected]

Keywords: Systematic review, case study reports,

Clinical research report, systematic review services,

systematic review writing, Clinical research services,

medical writing services.

I. INTRODUCTION

A systematic analysis seeks to gather data to address

a specific study issue. This entails locating all

primary research related to the specified review issue,

critically evaluating the research, and synthesizing

the results. Systematic analyses may draw together

various forms of information to analyze or clarify the

context. They may incorporate results from different

scientific trials to create a new integrated finding or

inference. Any study topic can be addressed using

systematic reviews. Curiosity in a subject and a need

to address a particular question can motivate a

systematic analysis.The question should define the

specific demographic to which the question refers and

any action and concern results. A well-defined study

issue will aid in the clarification of the eligibility

criterion for the inclusion of related studies (and

exclusion of irrelevant studies). For comparatively

straightforward systematic reviews of intervention

efficacy, the "PICO" paradigm is often used to inform

the systematic review topic(1)

. The PICO method for

framing systematic review study questions is

explained in this article.

II. EVIDENCE-BASED MEDICINE

PROFESSIONAL PRACTICE

Evidence-based medicine (EBM) involves

incorporating professional practice, the best available

scientific data, and the patient's principles and

interests into clinical decision-making. The steps in

practising EBM are based on the patient. They

include posing well-focused questions, looking for

the best possible data, assessing the relevance of that

evidence, and then adapting the findings to the

patient's treatment. Universal access to healthcare

information and knowledge-based resources is

needed to sustain 21st-century health care and EBM

practice. To address scientific questions, clinicians

and educators now use various tools and interfaces to

scan the biomedical literature. According to the

literature, often clinical inquiries go unanswered

because of difficulty formulating a specific topic,

forgetting the issue, a lack of access to knowledge

services, and a lack of search skills(2)

.

The first and arguably most critical move in the EBM

process is to formulate a well-focused topic. It can be

challenging and time-consuming to find adequate

tools and look for valid information without a well-

focused query. EBM practitioners often use a

specialized system known as PICO to shape the query

and promote the literature review. Patient Problem,

Intervention, Comparison, and Outcome is an

abbreviation for PICO. The PICO concept can be

extended to PICOTT by including details about the

kind of question being posed (therapy, diagnosis,

prognosis, damage, and so on) and the best kind of

research design for that specific question. Using this

approach assists the clinician in articulating the core

parts of the therapeutic query that are most relevant to

the patient and supports the evaluation process by

defining the key principles for an appropriate search

strategy(3)

.

III. PICO STRATEGY TO FRAME THE

RESEARCH QUESTION

Successful search methods are usually well-structured

and based on a PICO architecture. Population

Intervention Comparison Outcome (PICO) systems

assist the searcher in categorizing search words. Since

the medical model of study would usually be

identified by; a target demographic, for example,

children; an intervention, for example, an exercise

regime; the form of comparison, for example, a

randomized control trial; and effect, for example,

weight control, PICO is very good at recognizing

medical literature where systematic analysis is

popular. A well-constructed study query should

include four components. The PICO model is a useful

method for grouping and narrowing down a study

issue into a searchable query, and dividing the PICO

components aids in the identification of search

terms/concepts to use in literature searches.

P - Patient, problem, population

I ‑ Intervention, prognostic factor, exposure

C ‑ Comparison

O ‑ Outcome

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The PICO strategy results in a well-constructed test

topic, which leads to a study design that yields the

highest degree of proof(4)

.

IV. PICO FRAMEWORK

Finding appropriate resources and useful facts

without a well-focused query can be difficult and

time-consuming(5)

.

Keep the following points in mind when creating the

PICO question:

Your patient is both a part of a society and an individual who has (or is at risk of having). As a

result, in addition to age and gender, you can

need to weigh race, social class, or other

demographic factors.

A comparison is not necessarily present in a PICO study.

The best proof comes from rigorous trials of statistically meaningful results, but outcomes can

be observable(6)

.

An outcome should preferably assess clinical well-being or quality of life rather than

alternatives such as experimental test outcomes.

V. PICO ELEMENTS AS PERDOMAIN

When developing your question using the PICO

system, consider the sort of question you are posing

(therapy, prevention, diagnosis, prognosis, etiology).

The table below shows how Problems, Interventions,

Comparisons, and Outcomes differ depending on

your question's type (domain)(7)

.


VI. CREATING A QUESTION STATEMENT

It is simple to compose your question statement after

clearly defining your question's key elements using

the PICO system. Any illustrations are given in the

table below(8)

.


VII. CONCLUSION

These structures are instruments for guiding the

creation of a search strategy. A slight modification

to the medical query structures, usually as basic as

moving patient to population, allows structuring

questions from both library and information science

fields. Rather than considering any of these systems

to be fundamentally different, consider the

following elements: timeline, length, background,

(health care) setting, atmosphere, type of issue,

type of study nature, practitioners, visibility,

outcomes, stakeholders, and scenario. Where

required, these can be used interchangeably.

Maintaining an understanding of the various

possibilities for structuring searches broadens the

frameworks' future uses. A thorough understanding

of the structures also allows the searcher to tailor

tactics to each situation rather than adapt a search

situation to a system(9)

.

REFERENCES

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MI, Lehnen AM. Effects of Different Types of

Exercise Training on Endothelial Function in

Prehypertensive and Hypertensive Individuals: A

Systematic Review. Arq. Bras. Cardiol.

2021;116(5):938-47.

[2] Kloda, L. A., Boruff, J. T., &Cavalcante, A. S.

(2020). A comparison of patient, intervention,

comparison, outcome (PICO) to a new, alternative

clinical question framework for search skills,

search results, and self-efficacy: a randomized

controlled trial. Journal of the Medical Library

Association : JMLA, 108(2), 185–194.

https://doi.org/10.5195/jmla.2020.739

[3] Miller, V., Hamler, T., Beltran, S., & Burns, J.

(2020). The Social Worker in the Nursing Home: A

Systematic Review of the Literature from 2010 to

2020. Innovation in Aging, 4(Suppl 1), 960.

https://doi.org/10.1093/geroni/igaa057.3508

[4] Milde, AM, Gramm, HB, Paaske, I, Kleiven,

PG, Christiansen, Ø, SkaaleHavnen, KJ. Suicidality

among children and youth in Nordic child welfare

services: A systematic review. Child & Family

Social Work. 2021; 1– 12.

https://doi.org/10.1111/cfs.12832

[5] 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.

[6]Palaskar JN. Framing the research question

using PICO strategy. J Dent Allied Sci 2017;6:55.

[7] https://canberra.libguides.com/evidence

[8] Schardt, C., Adams, M. B., Owens, T., Keitz,

S., &Fontelo, P. (2007). Utilization of the PICO

framework to improve searching PubMed for

clinical questions. BMC Medical Informatics and

Decision Making, 7, 16. doi:

http://dx.doi.org/10.1186/1472-6947-7-1.

[9] Fineout-Overholt, E., & Johnston, L. (2005).

Teaching EBP: asking searchable, answerable

clinical questions. Worldviews On Evidence-Based

Nursing, 2, 157-160.
https://pubrica.com/academy/essential-ingredients-of-a-scientific-research-proposal-for-medical-science/https://doi.org/10.5195/jmla.2020.739https://doi.org/10.1093/geroni/igaa057.3508https://doi.org/10.1111/cfs.12832https://canberra.libguides.com/evidence