The concept of PICO was introduced in 1995 by Richardson et al. to break down clinical questions into searchable keywords.
The PICO framework and its variations were developed to answer health-related questions. PICO is a mnemonic formula originally developed to help investigators frame research questions when designing a study.
|Population / Patient / Problem
|What population or patient group are the investigators working with? It can also refer to the problem being investigated
|What intervention is the intervention group receiving?
|Comparison / Control
|Is there a control group, and if so, what intervention is the control group receiving?
|What outcomes are being measured and how?
The PICO framework is the most used model for structuring clinical questions because it captures each key element required for a focused question. It can help you form a question that focuses on the most important issue for a patient, problem or a population. It helps to Identify key terms to use in a search for evidence and select results that directly relate to the situation.
PICO mostly focuses on intervention (or therapy) clinical questions. It can be less suitable for other question types (such as qualitative research) as It doesn’t account for some complexities like considering feasibility, context, and sociocultural acceptability.
PICO can be useful to use in critical appraisal to help identify whether the investigators or researchers conducting a Randomised Controlled Trial (RCT) have been clear about the basic elements of the Research Hypothesis or Research Question.
There are many other mnemonics out there, but some of the variations of PICO are:
PECO stands for:
Compared to PICO, PECO replaces "Intervention" (a planned procedure) with "Exposure" (an unintentional occurrence or happening.)
PECO is a framework for formulating good questions to explore the association of environmental and other exposures with health outcomes.
‘I haven't identified an intervention’
PICOC stands for:
Compared to PICO, add a "C" for "Context.
PICOC is a solid strategy for questions relating to cost effectiveness, economic evaluations, service improvements etc.
‘I'm interested in social interventions, ones that are depending on context for effectiveness.’
CoCoPop stands for:
‘I want to look more deeply into the prevalence of a condition, disease, problem, or symptom, but I don't necessarily have an intervention identified or want to compare interventions’
SPICE stands for:
SPICE is a framework for qualitative questions evaluating experiences, meaningfulness etc.
‘I want to investigate attitudes or opinions.’
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