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1. Copyright © 2021 pubrica. All rights reserved 1
The PICO Framework for Framing Systematic
Review Research Questions
Dr. Nancy Agnes, Head, Technical Operations, Pubrica, sales@pubrica.com
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

2. Copyright © 2021 pubrica. All rights reserved 2
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)
.

3. Copyright © 2021 pubrica. All rights reserved 3
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)
.

4. Copyright © 2021 pubrica. All rights reserved 4
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)
.
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[2] Kloda, L. A., Boruff, J. T., &Cavalcante, A. S.
(2020). A comparison of patient, intervention,
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clinical question framework for search skills,
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https://doi.org/10.1111/cfs.12832
[5] Alex Pollock and Eivind Berge, How to do a
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[6]Palaskar JN. Framing the research question
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[7] https://canberra.libguides.com/evidence
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Teaching EBP: asking searchable, answerable
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