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The PICO process (or framework) is a
mnemonic A mnemonic ( ) device, or memory device, is any learning technique that aids information retention or retrieval (remembering) in the human memory for better understanding. Mnemonics make use of elaborative encoding, retrieval cues, and image ...
used in
evidence-based practice Evidence-based practice (EBP) is the idea that occupational practices ought to be based on scientific evidence. While seemingly obviously desirable, the proposal has been controversial, with some arguing that results may not specialize to indiv ...
(and specifically
evidence-based medicine Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients". The aim of EBM is to integrate the experience of the clinician, the values of t ...
) to frame and answer a clinical or health care related question, though it is also argued that PICO "can be used universally for every scientific endeavour in any discipline with all study designs". The PICO framework is also used to develop literature search strategies, for instance in
systematic reviews A systematic review is a scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from published studies on t ...
. The PICO acronym has come to stand for: * PPatient, problem or population * IIntervention * CComparison, control or comparator * OOutcome(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: * PPatient, problem or population * IInvestigated condition (e.g. intervention, exposure, risk/ prognostic factor, or test result) * CComparison condition (e.g. intervention, exposure, risk/ prognostic factor, or test result respectively) * OOutcome(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: * T - Timing (e.g. duration of intervention, or date of publication) * S - Study type (e.g.
randomized controlled trial A randomized controlled trial (or randomized control trial; RCT) is a form of scientific experiment used to control factors not under direct experimental control. Examples of RCTs are clinical trials that compare the effects of drugs, surgical t ...
, cohort study, etc.)


PICO as a universal technique

It was argued that PICO may be useful for every scientific endeavor even beyond clinical settings. This proposal is based on a more abstract view of the PICO mnemonic, equating them with four components that is inherent to every single research, namely (1) research object; (2) application of a theory or method; (3) alternative theories or methods (or the
null hypothesis In scientific research, the null hypothesis (often denoted ''H''0) is the claim that no difference or relationship exists between two sets of data or variables being analyzed. The null hypothesis is that any experimentally observed difference is ...
); and (4) the ultimate goal of knowledge generation. This proposition would imply that the PICO technique could be used for teaching
academic writing Academic writing or scholarly writing is nonfiction produced as part of academic work, including reports on empirical fieldwork or research in facilities for the natural sciences or social sciences, monographs in which scholars analyze culture, ...
even beyond medical disciplines.


Examples

Clinical question: "In children with
headache Headache is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of depression in those with severe headaches. Headaches can occur as a result ...
, is
paracetamol Paracetamol, also known as acetaminophen, is a medication used to treat fever and mild to moderate pain. Common brand names include Tylenol and Panadol. At a standard dose, paracetamol only slightly decreases body temperature; it is inferio ...
more effective than
placebo A placebo ( ) is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets (like sugar pills), inert injections (like Saline (medicine), saline), sham surgery, and other procedures. In general ...
against pain?" * Population = Children with headaches; keywords = children + headache * Intervention = Paracetamol; keyword = paracetamol * Compared with = Placebo; keyword = placebo * Outcome of interest = Pain; keyword = pain
Pubmed PubMed is a free search engine accessing primarily the MEDLINE database of references and abstracts on life sciences and biomedical topics. The United States National Library of Medicine (NLM) at the National Institutes of Health maintai ...
(health research database) search strateg
children headache paracetamol placebo pain
Clinical question: "Is the risk of having breast cancer higher in symptom-free women with a positive mammography compared to symptom-free women with a negative mammography?" * Population = Women without a history of breast cancer * Investigated test result = Positive result on mammography * Comparator test result = Negative result on mammography * Outcome of interest = Breast cancer according to biopsy (or not)


References

Evidence-based practices {{med-stub