Eriksen 2018

Appraisal of: "Eriksen, M.B., & Frandsen, T.F. (2018). The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review. Journal of the Medical Library Association, 106(4), 420–431."

Reviewer(s): 

Juilet Brown

Alan Lovell

MS Copilot

Full Reference:
Eriksen, M.B., & Frandsen, T.F. (2018). The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review. Journal of the Medical Library Association, 106(4), 420–431. DOI: 10.5195/jmla.2018.345. 

Short description: 

This systematic review investigates whether using the PICO framework as a search strategy tool improves the quality of literature searches. The authors conducted a comprehensive search across nine databases and screened 2,163 records, ultimately including three studies for qualitative analysis. These studies compared PICO to other models such as PICOS, SPIDER, and unguided searching, assessing outcomes like sensitivity and precision. 

Findings suggest that PICO may improve sensitivity and precision in some contexts, but results were inconsistent and limited by methodological differences across studies. None of the included studies assessed time spent on searching. Due to heterogeneity and risk of bias, no quantitative synthesis was performed. The authors conclude that more rigorous, well-designed studies are needed to evaluate the effectiveness of PICO and other conceptual models in search strategy development. 

Limitations stated by the author(s): 

• Only three studies met inclusion criteria, limiting generalizability.  

• No validated tool exists for assessing bias in studies of search strategy tools; a custom tool was used.  

• High or unclear risk of bias was found in all included studies.  

• Heterogeneity in study design and outcomes prevented quantitative analysis.  

• No studies reported time spent on literature searching. 

Limitations stated by the reviewer(s): 

• The review does not provide conclusive evidence due to the small number of included studies.  

• The custom risk-of-bias tool, while thoughtfully constructed, lacks external validation.  

• Differences in the number of search blocks across models confound comparisons.  

• The impact of outcome-related search terms on sensitivity remains unresolved.  

• The review focuses on sensitivity and precision but omits broader measures of search effectiveness or utility. 

Study Type: 

Systematic Review (Methodological Evaluation) 

Related Chapters: 

Clinical effectiveness

Tags: 

• PICO

• Search quality