Watch the short video Patient Intervention Comparator Outcome from The Cochrane Collaboration that explains what PICO(TS) means and how it can be applied (YouTube, 2m 57s).
Download the search framework template you need to use to help keep your search on track.
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Search frameworks can be helpful tools when starting your search as they:
There are many different search frameworks, and which one you choose to use will depend on which framework best suits your question. Below, you will find some information for a selection of search frameworks.
You don't have to use a framework to help build and guide your search, but it can help to save you time and shows that you have taken a structured approach to searching the literature.
The PICO framework (Richardson et al., 1995) is a commonly used tool that helps you think about more specific characteristics relating to the Population, Intervention, Comparison, and Outcomes of your search question and then turn it into structured searchable concepts. The PICO framework is most useful for:
Depending on your question and the type of information you are looking for, you may not always need to use every aspect of the framework to build a workable search strategy. Don't worry about trying to make all the parts of your question fit the framework.
|
P Patient, population, or problem |
What population characteristics are important or what issue has the patient presented with?
|
|
I Intervention or exposure |
What is the main intervention of interest?
|
|
C Comparison or control |
What are you comparing your intervention against? You may want to know if one drug is better than another when treating a particular condition or whether one test is more effective than another when diagnosing a condition. Remember: sometimes there is no comparison. |
|
O Outcome |
What outcomes are you interested in? They could be:
|
Let's look at how PICO can be used to develop the following search query: which is more effective in reducing pyrexia (high body temperature) in infants, paracetamol or ibuprofen?
| Patient, population, problem | The population is ... | infants |
|---|---|---|
| Intervention/exposure | The intervention is ... | paracetamol |
| Comparison/control | The comparison is... | ibuprofen |
| Outcome | The outcome is... | reducing pyrexia |
Once you have decided on the basic key terms for your question, you can begin to build your search. This is discussed further in the Strategies for searching guide.
Sometimes, you may need to include additional concepts in the PICO framework to cover key aspects of your question. Variants of the PICO framework include:
PICOT: T stands for timing. This can be useful if you need to know what the research evidence says about when tests or interventions should take place or how long a treatment period should be.
PICOS: S stands for setting. This can be helpful when examining a social issue or how different healthcare settings may impact care.
If your question doesn't fit easily into the PICO framework, you may want to use a different tool. Click on the menu tabs below to learn more about other commonly used search frameworks.
Population - Exposure - Outcome.
This framework is useful when searching for qualitative information to answer questions about exposure to an event, treatment, or disease (Bettany-Saltikov, 2012). It can be especially useful when investigating a prognosis or risk of developing a certain condition as a result of exposure or a pre-existing condition.
Example PEO question:
What are the daily lived experiences of mothers who have been diagnosed with postnatal depression?
| Population and their problems |
How would you describe the patient or population of interest? |
Mothers |
| Exposure |
What has the population been exposed to? What have they experienced? |
Diagnosed with postnatal depression |
| Outcomes or themes |
Outcome(s) of interest
|
Daily lived experiences |
Sample - Phenomenon of Interest - Design - Evaluation - Research type
This framework is useful for qualitative and mixed methods research questions that seek to understand subjective concepts such as experiences, attitudes, or perceptions (Cooke et al., 2012).
Example SPIDER question:
What are the experiences and perceptions of parents regarding early intervention for their child's speech and language development?
| Sample | Who or what is the population or group being studied? | Parents of children aged 0-5 years with speech or language development challenges |
| Phenomenon of Interest |
What is the topic or focus of the research question? |
Parental experiences and perceptions of early interventions for their child's speech and language development |
| Design | What methodology or approach was used in the research? | Studies using interviews, focus groups, or case studies |
| Evaluation | What outcomes or measures were used to assess the impact? | Insights into parental satisfaction, perceived effectiveness, or emotional responses |
| Research type | What type of research evidence is it? | Qualitative research focused on experiences and perceptions |
Setting - Perspective - Intervention, interest, or exposure - Comparison - Evaluation
The SPICE framework works well for questions evaluating the outcomes, results, or impacts of a service, intervention, or project (Brice & Booth, 2004).
Example SPICE question:
In residential care facilities, do therapy animal visits, as opposed to no therapy animal visits, reduce feelings of loneliness in residents?
| Setting | What is the location of the research or study? | Residential care facilities |
| Perspective | What/who is the group being studied? | Residents |
| Intervention, interest, or exposure | Treatment, prognostic factor, management strategy, diagnostic test, or exposure | Therapy animal visits |
| Comparison | Control or alternative management strategy | No therapy animal visits |
| Evaluation | What are the outcomes you need to measure? | Reduced feelings of loneliness |
Expectation - Client group - Location - Impact - Professionals - Service
The ECLIPSE framework is helpful for questions involving health and social care management, services, or policies (Wildridge & Bell, 2002).
Example ECLIPSE question:
How can I increase access to community-based parenting support services to help parents of children with behavioural challenges?
| Expectation | What innovation, improvement, or information is required? | To increase access to parenting support services |
| Client group | What client group is the focus of the study or intervention? | Parents of children with behavioural challenges |
| Location | Where is the client group or service located? | Community settings |
| Impact | What are the desired outcomes, and how might they be measured? | Improved access to parenting support services |
| Professionals | Who is involved in delivering or improving the service? | Social workers, community groups, parenting support groups |
| Service | What service is being examined? | Community-based parenting support services for parents of children with behavioural challenges |
Population - Concept - Context
The PCC framework can help you to frame a question for a scoping review, highlighting the important concepts for the literature review. It can be useful when you are undertaking qualitative or exploratory research or when you have a broad search question that doesn't involve specific outcomes or comparisons.
Example PCC question:
What are the experiences of caregivers supporting people living with dementia in rural Australia?
| Population |
Important characteristics of participants, such as age, gender, ethnicity, or other qualifying criteria. You may not need to include this element if your question doesn't focus on a specific condition or group. |
Caregivers of people living with dementia |
| Concept |
What are you interested in researching? This could be an intervention, activity, or phenomena of interest. |
Experiences (qualitative data, lived experiences, perceptions) |
| Context |
Are you interested in a specific setting or location?
|
Rural Australia |
Brice, A., & Booth, A. (2004). Formulating answerable questions. In A. Booth & A. Brice (Eds.). Evidence-based practice for information professionals. Facet Publishing.
Cooke, A., Smith, D., & Booth, A. (2012). Beyond PICO: The SPIDER tool for qualitative evidence synthesis. Qualitative Health Research, 22(10), 1435-1443. https://doi.org/10.1177/1049732312452938
Bettany-Saltikov, J. (2012). How to do a systematic literature review in nursing: a step-by-step guide. McGraw-Hill Education.
Richardson, W. S., Wilson, M. C., Nishikawa, J., & Hayward, R. S. A. (1995). The well-built clinical question: A key to evidence-based decisions. ACP Journal Club, 123(3), A12-13.
Wildridge, V. & Bell, L. (2002). How CLIP became ECLIPSE: A mnemonic to assist in searching for health policy/ management information. Health Information & Libraries Journal, 19(2),113–115. https://doi.org/10.1046/j.1471-1842.2002.00378.x