Critical Appraisal Skills Programme

PICO Search Strategy Tips & Examples

When evaluating research in healthcare, it's essential to have a structured approach to searching for relevant information. One widely used framework for formulating research questions and search strategies is the PICO framework. In this blog post, we will look at the PICO search strategy, providing tips and examples to help you navigate the complexities of clinical research with confidence. 

Why Use PICO for a Search Strategy? 

  • By using PICO, researchers can reduce bias and increase transparency in their search strategies. 
  • The PICO framework can be easily adapted for use in various fields of study and research areas. 
  • It helps to structure literature reviews and systematic reviews more effectively. 
  • Using PICO can lead to more relevant and reliable research findings. 
  • Using PICO helps to formulate a clear and concise research question.

What Are the Limitations of Using PICO for a Search Strategy?

  • PICO may not always capture the nuances of real-life patient care, where scenarios often overlap from neatly categorised components. 
  • The effectiveness of a PICO-based search heavily relies on the selection of search terms and keywords, and identifying the most appropriate and effective terms can be challenging and may necessitate a process of trial and error to refine and perfect a search strategy. 
  • If researchers focus too much on strictly adhering to PICO guidelines, they may overlook potentially relevant literature that doesn't fit neatly into these categories.

Tips for a Successful PICO Search Strategy

  • Consider all aspects of the PICO framework, including patient population, intervention, comparison, and outcome measures when developing your search strategy.
  • Use Boolean operators (AND, OR, NOT) to combine search terms and tailor your search to the research question at hand.
  • Include synonyms or related terms for key concepts to broaden your search while maintaining relevance (e.g., medication, drug, pharmaceutical).
  • Seek feedback from colleagues or librarians during the development phase of your search strategy to ensure comprehensiveness and validity. 
  • Keep track of your search strategy using tools such as citation management software (e.g., EndNote) or a spreadsheet to ensure reproducibility and transparency. 
  • Regularly revisit and revise your search strategy throughout the research process as necessary based on new information or emerging evidence.

Examples of PICO Search Strategy Success

Let’s explore a scenario that many healthcare professionals might find familiar. Imagine a research question focusing on the management of type 2 diabetes:

P: For adults with type 2 diabetes,
I: Does incorporating a Mediterranean diet
C: Compared with a standard diabetic diet,
O: Improve glycaemic control?

Employing the PICO search strategy, researchers can systematically navigate through the existing literature to pinpoint studies that directly address dietary intervention and its effect on glycaemic control in adults with type 2 diabetes. This structured approach ensures that the search is both comprehensive and focused.

Another example could involve the investigation of pain management strategies:

P: In adults undergoing knee replacement surgery,
I: Is the use of acupuncture
C: Compared to pharmacological pain management,
O: Effective in reducing post-operative pain?

With PICO, this example shows how breaking down a complex research question into manageable, specific components gives a targeted search, leading to the identification of relevant studies that offer insight into effective pain management strategies post-surgery. 

Advancing Your PICO Skills

Participating in workshops focused on evidence-based practice and research methodologies will not only enrich your understanding but also sharpen your critical thinking and search capabilities. 

CASP runs workshops to further your confidence when reading research, and also has online training focusing on finding and searching for evidence.

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