Utilization of the PICO framework to improve searching PubMed for clinical questions

By C. Schardt, Martha B. Adams, Thomas Owens, S. Keitz, P. Fontelo. BMC Medical Informatics Decis. Mak., 2007

1,604 citations recorded by the source corpus.

BackgroundSupporting 21st century health care and the practice of evidence-based medicine (EBM) requires ubiquitous access to clinical information and to knowledge-based resources to answer clinical questions. Many questions go unanswered, however, due to lack of skills in formulating questions, crafting effective search strategies, and accessing databases to identify best levels of evidence.MethodsThis randomized trial was designed as a pilot study to measure the relevancy of search results using three different interfaces for the PubMed search system. Two of the search interfaces utilized a specific framework called PICO, which was designed to focus clinical questions and to prompt for publication type or type of question asked. The third interface was the standard PubMed interface readily available on the Web. Study subjects were recruited from interns and residents on an inpatient general medicine rotation at an academic medical center in the US. Thirty-one subjects were randomized to one of the three interfaces, given 3 clinical questions, and asked to search PubMed for a set of relevant articles that would provide an answer for each question. The success of the search results was determined by a precision score, which compared the number of relevant or gold standard articles retrieved in a result set to the total number of articles retrieved in that set.ResultsParticipants using the PICO templates (Protocol A or Protocol B) had higher precision scores for each question than the participants who used Protocol C, the standard PubMed Web interface. (Question 1: A = 35%, B = 28%, C = 20%; Question 2: A = 5%, B = 6%, C = 4%; Question 3: A = 1%, B = 0%, C = 0%) 95% confidence intervals were calculated for the precision for each question using a lower boundary of zero. However, the 95% confidence limits were overlapping, suggesting no statistical difference between the groups.ConclusionDue to the small number of searches for each arm, this pilot study could not demonstrate a statistically significant difference between the search protocols. However there was a trend towards higher precision that needs to be investigated in a larger study to determine if PICO can improve the relevancy of search results.

Subfields: General Health Professions, Statistics and Probability

View Paper: https://www.semanticscholar.org/paper/07224f9c21ce65bad806d655b60fc9b33562fe72

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In General Health Professions

1. Zhiyong Lu
2. J. Spence

In Statistics and Probability

1. M. Sampson
2. Zhiyong Lu
3. Mark S. Tremblay
4. Anthony Okely

Citations in the corpus

• The Effectiveness of Artificial Intelligence Conversational Agents in Health Care: Systematic Review (2020, methodology): “The population, intervention, comparison, and outcome framework [25] was used to develop the search strategy, which was implemented following the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols) checklist [26].”
• Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth. (2016, methodology): “The participants, interventions, comparisons, outcomes and study design (PICOS) framework (Schardt et al. 2007) was followed to identify key study concepts in the research question a priori, and to facilitate the search process.”
• Systematic review of the relationships between physical activity and health indicators in the early years (0-4 years) (2017, background): “screening) determined Population, Intervention, Comparison, and Outcome (PICO) study criteria [25].”
• PubMed and beyond: a survey of web tools for searching biomedical literature (2011, methodology): “Other proposals for an alternative input interfaces facilitate user-specific questions (PICO, askMedline), allow non-English queries (BabelMeSH), and promote use of sliders to set limits (SLIM).”
• Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth. (2016, methodology): “The participants, interventions, comparisons, outcomes and study design (PICOS) framework (Schardt et al. 2007) was followed to identify key study concepts in the research question a priori and to facilitate the searching process.”