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Systematic Reviews

Why use PICO?

Systematic reviews require focused clinical questions. PICO is a useful tool for formulating such questions. For information on PICO and other frameworks please see our tutorial below.

PICO example for quantitative studies

The PICO (Patient, Intervention, Comparison, Outcome) framework is commonly used to develop focused clinical questions for quantitative systematic reviews.    

Patient, Population or Problem

What are the characteristics of the patient or problem? What is the condition or disease you are interested in?

Intervention or exposure What do you want to do with this patient (e.g. treat, diagnose, observe)?
Comparison What is the alternative to the intervention (e.g. placebo, different drug, surgery)?
Outcome What are the relevant outcomes (e.g. morbidity, death, complications)?

Sample topic: 

In middle aged women suffering migraines, is Botulinium toxin type A compared to placebo effective at decreasing migraine frequency?

P - Middle aged women suffering migraines

I - Botulinium toxin type A

C - Placebo

O - Decreased migraine frequency

 

Use the following worksheet to complete a search strategy:

PICo, SPICE or SPIDER example for qualitative studies

The PICO (Patient, Intervention, Comparison, Outcome) framework is commonly used to develop focused clinical questions for quantitative systematic reviews. A modified version, PICo, can be used for qualitative questions.

Population                              What are the characteristics of the patient or population? What is the condition or disease you are interested in?
Interest What is the phenomena of interest? A defined event, activity, experience or process?
Context What is the setting or distinct characteristics?

Sample topic:

What are caregivers' experiences with providing home-based care to patients with HIV/AIDS in Africa?

P - Caregivers providing home-based care to persons with HIV/AIDS

I - Experiences

Co - Africa


Use the following worksheet to create a search strategy:

The SPIDER framework is an alternative search strategy tool (based on PICo) for qualitative/mixed methods research.

Sample

Who is the sample or population of interest?                                                                                   

Phenomenon of Interest         What is the phenomena of interest? A defined event, activity, experience or process?
Design What types of study methods are you interested in?
Evaluation What are the evaluation outcomes? (May be subjective - opinions, feelings etc.)
Research type                            What type of research are you interested in? Qualitative or mixed method (qualitative & quantitative)?

Sample topic: What are the experiences of women undergoing IVF treatment?

S - Women

PI - IVF treatment

D - Questionnaire or survey or interview

E - Experiences or views or attitudes or feelings

R - Qualitative or mixed method
 

SPICE can be used for both qualitative and quantitative studies. SPICE stands for Setting (where?), Perspective (for whom?), Intervention (what?), Comparison (compared with what?) and Evaluation (with what result?).


Sample topic: What are the coping skills of parents of children with autism undergoing behavioural therapy in schools?

S - Schools

P - Parents of children with autism

I - Behavioural therapy

C - None

E - Coping skills