PICO is a method for extracting the key concepts from a clinical question.
Search results will contain exactly the terms inside the quotation marks
Example: "lower back pain"
Called nesting when used with Boolean operators to group synonyms and related terms together
Example: (adjustment OR manipulation)
Truncation with an asterisk retrieves alternate word endings
Example: teach* retrieves: teach, teacher, teaches, teaching
PICO stands for: Patient/Problem, Intervention, Comparison and Outcome. When considering a clinical problem, use PICO to analyze the most important concepts to research.
|
P |
Patient or Problem: Demographic characteristics of the patient such as age, sex; condition or other factor, such as: congestive heart failure, hypoglycemic, smoker, obese |
|
I |
Intervention: Treatment, prognostic factor, exposure, such as a drug, test, surgery, adjustment |
|
C |
Comparison: Are you trying to decide between two treatments/drugs/procedures, etc.? (optional/placebo/”sham”) |
|
O |
Outcome: What is desired for the patient? |
Example: In adult patients with whiplash following a car accident, how effective is chiropractic care compared to exercise in restoring range of motion?
|
P |
adult, whiplash |
|
I |
chiropractic care |
|
C |
exercise |
|
O |
restoring range of motion |
Note: Not all parts of PICO will apply to every clinical question. For example, not every clinical question needs a comparator and sometimes it can be challenging to find research that compares two different interventions in the same article. Instead, you might find implicit comparisons between standard care, placebo, or non-intervention.
1. Using your PICO question, identify the key words - those terms that are most specific to your question.
Example: Among elderly nursing home residents with depression, are therapy animal visits effective in managing or reducing depressive symptoms?
2. Brainstorm synonyms for those words.
Elderly: geriatric, senior citizens, aged
Nursing home residents: assisted living facility, long-term care facility
Therapy animal visits: animal assisted therapy, equine therapy, canine therapy, pet therapy, animal based therapy
Depression: depressive symptoms, emotional depression, major depressive disorder
3. Create a search strategy by using Boolean operators to connect your search terms.
Example: (elderly OR geriatric OR "senior citizen" or aged) AND ("therapy animal" OR "animal assisted therapy") AND depression
4. Test your search strategy in your chosen database and review your results.
Example: chiropractic AND manipulation
Example: manipulation OR adjustment
Example: manipulation NOT adjustment