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Population, Intervention, Comparison, Outcomes and Study (PICOS) design as a framework to formulate eligibility criteria in systematic reviews
Abstract
Dear editor, We read with great interest the review entitled ‘Paracetamol vs other analgesia in adult patients with minor musculoskeletal injuries: a systematic review’,1 published in the Emergency Medicine Journal . Although the authors have stated that they followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, there is a methodological issue regarding the study discussed in this letter, which …
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“The eligibility criteria were developed using the PICOS framework and adapted for the scoping purpose of this review [19].”
From Digital health technologies in oncology services: A scoping review of clinical implementation, organisational evidence gaps, and policy implications (2026) · cites this paper as [19]
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Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
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Brown, P., Brunnhuber, K., Chalkidou, K., Chalmers, I., Clarke, M., Fenton, M., Forbes, C., Glanville, J., Hicks, N. J., Moody, J., et al. (2006) · BMJ · doi:10.1136/bmj.38987.492014.94 · Cited by 381
Systematic Reviews: Are They Actually Well Conducted and Reported in Accordance with PRISMA?
Gholizadeh, M., Amir‐Behghadami, M., & Janati, A. (2020) · Bulletin of Emergency and Trauma · doi:10.29252/beat-080110 · Cited by 15
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Comment on: Systematic review of functional outcome and quality of life after total pancreatectomy
Amir‐Behghadami, M., Janati, A., & Gholizadeh, M. (2020) · British journal of surgery · doi:10.1002/bjs.11535 · Cited by 5
Self-citationJanati, A., Amir‐Behghadami, M., & Arab‐Zozani, M. (2020) · Injury · doi:10.1016/j.injury.2020.02.018 · Cited by 5
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Research works printed but not linked: 1
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“The inclusion criteria were determined according to the PICOS method (population, issue of interest, comparison, outcome and study design) (Amir-Behghadami and Janati, 2020).”
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“This term was combined with a range of supplementary key words relevant to nursing education using a PICOS (Population, Intervention, Comparison, Outcomes and Study) framework [19].”
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“PICO (Population, Inter-vention, Comparison, Outcomes) [232], PICOS (PICO plus Study)[233],andSPIDER(Sample,PhenomenonofInterest, Design, Evaluation, Research type) [234] are long-standing, widely used templates in these domains.”
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“To address the main objective, study inclusion and exclusion criteria were structured using the PICOS framework (population, intervention, comparison, outcome, study design) as a worksheet [22] (Table 1).”
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“The inclusion and exclusion criteria followed the PICOS framework, which included population, intervention, comparison, outcome, and study design [37].”
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“The PICOS framework (Amir-Behghadami and Janati, 2020) was employed to identify eligibility and exclusion criteria.”
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“This research aims to conduct a systematic review comparing similar studies concerning study design, participants, interventions, comparators, and outcomes (PICO framework) (Amir-Behghadami & Janati, 2020).”
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“The widely used PICOS (Population, Intervention, Comparison, Outcomes and Study) framework [20,21] was used for the umbrella review.”
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“The ‘Participant-Intervention-Comparator-Outcomes-Study design’ (PICOs) framework [19] was followed to formulate the following eligibility criteria:”
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“The internationally accepted Population-Intervention-Comparison-Outcome-Study (PICOS) design principles were used for this study (Amir-Behghadami & Janati, 2020) (Table 1).”
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“Inclusion and exclusion criteria Eligible studies met the criteria of the PICOS (participants, interventions, comparators, outcomes, and study design) [37].”
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“The eligibility criteria followed the PICOS (Populations, Interventions, Comparators, Outcomes, Study Design) framework [30].”
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“The population, intervention, comparison, outcome, and study setting/ design (PICOS) approach was used to define the eligibility criteria for relevant studies.(26) The inclusion criteria were (a) population: stroke patients (no restrictions on age, gender, onset of stroke symptoms, or stage of stroke); (b) interventio…”
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“The detailed inclusion criteria were formulated f o l l o w i n g t h e “Population-Intervention-Comparator-Outcomes-Study design” (PICOS) framework [30].”
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“Several studies [28,35,38,48,58] offered dietary advice and exercise prescriptions but needed to have targeted weight loss strategies.”
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“The inclusion criteria were guided by the PICOS (Population, Intervention, Comparator, Outcome, Study design) framework [41, 42], (full details in Supplementary material S2).”
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“According to the Participants Intervention Comparison Outcome Study design (PICOS) schema [28], the review aimed to investigate human patients of any age, sex, ethnicity, or malocclusion with unilateral impaction of maxillary central incisors.”
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Islam, B., Ibrahim, T. I., Wang, T., Wu, M., & Qin, J. (2025) · Journal of Global Health · doi:10.7189/jogh.15.04049 · Cited by 34
“We defined our inclusion and exclusion criteria per the PICOS framework [ 44 ] ( Table 1 ).”
Seid, A., Debebe, Z. Y., Ayelign, A., Abeje, M., Endris, B. S., Assefa, M., & Jemal, A. (2025) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.70012 · Cited by 32
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Martí, Y., Ribero, V. A., Batson, S., Mitchell, S., Gorni, K., Gusset, N., Oskoui, M., Servais, L., Deconinck, N., McGrattan, K. E., et al. (2024) · Journal of Neuromuscular Diseases · doi:10.3233/jnd-230248 · Cited by 42
“Eligibility criteria were determined based on the Population, Intervention, Comparison, Outcomes, and Study (PICOS) framework [28].”
MethodSu, Z., Cheshmehzangi, A., Bentley, B. L., McDonnell, D., Šegalo, S., Aḥmad, J., Chen, H., Terjesen, L. A., Lopez, E., Wagers, S. M., et al. (2022) · Systematic Reviews · doi:10.1186/s13643-022-02150-9 · Cited by 35
“Considering eligibility criteria, having a clear and concrete understanding of the population and the specific research problem will help identify components of the PICOS framework applied to this study: namely the Population, Intervention, Comparison, Outcome, and Study design [42].”
MethodCangelosi, G., Sacchini, F., Mancin, S., Petrelli, F., Amendola, A., Fappani, C., Sguanci, M., Palomares, S. M., Gravante, F., & Caggianelli, G. (2025) · Vaccines · doi:10.3390/vaccines13050460 · Cited by 28
“The search strategy was developed using the PICOS framework (Population, Intervention, Comparison, Outcome, Study Design) [31], and was defined as follows: P, adults > 18 years; I, HPV vaccination programs in community settings; C, absence of adequate programs or presence of barriers; O, increased…”
Systematic Review of Quantitative Risk Quantification Methods in Construction Accidents
Kumi, L., Jeong, J., & Jeong, J. (2024) · Buildings · doi:10.3390/buildings14103306 · Cited by 28
Tuygunov, N., Khairunnisa, Z., Yahya, N., Aziz, A. A., Zakaria, M., Israilova, N., & Cahyanto, A. (2024) · Dental materials journal · doi:10.4012/dmj.2023-132 · Cited by 28
Antibiotic Use in Dental Implant Procedures: A Systematic Review and Meta-Analysis
Torof, E., Morrissey, H., & Ball, P. (2023) · Medicina · doi:10.3390/medicina59040713 · Cited by 28
Gasparini, S., Balestrini, S., Saccaro, L. F., Bacci, G. M., Panichella, G., Montomoli, M., Cantalupo, G., Bigoni, S., Mancano, G., Pellacani, S., et al. (2024) · American Journal of Medical Genetics Part C Seminars in Medical Genetics · doi:10.1002/ajmg.c.32099 · Cited by 28
“The search was designed following the Population, Interventions, Comparators, Outcomes, and Study design (PICOS) criteria (Amir-Behghadami & Janati, 2020).”
Systematic Literature Review of the Natural History of Spinal Muscular Atrophy
Ribero, V. A., Martí, Y., Batson, S., Mitchell, S., Gorni, K., Gusset, N., Oskoui, M., Servais, L., & Sutherland, C. (2023) · Neurology · doi:10.1212/wnl.0000000000207878 · Cited by 27
“The search was performed on May Eligibility criteria were based on the population, interventions, comparators, and outcomes framework 14 to identify relevant data (eTable 4, links.lww.com/WNL/D158).”
MethodIntra-operative applications of augmented reality in glioma surgery: a systematic review
Ragnhildstveit, A., Li, C., Zimmerman, M. H., Mamalakis, M., Curry, V. N., Holle, W., Baig, N., Uğuralp, A. K., Alkhani, L., Uğuralp, Z., et al. (2023) · Frontiers in Surgery · doi:10.3389/fsurg.2023.1245851 · Cited by 36
“Leveraging the Population, Intervention, Comparison, Outcomes, and Study design (PICOS) framework, study eligibility was evaluated in the qualitative synthesis.”
MethodInfluentialSaragih, I. D., Tonapa, S. I., Sun, T., Lin, C., & Lee, B. (2021) · Journal of Clinical Nursing · doi:10.1111/jocn.15856 · Cited by 30
Almasri, H., Zakuan, N., Amer, M., & Majid, M. R. (2021) · Studies of Applied Economics · doi:10.25115/eea.v39i4.4559 · Cited by 27
Wan Mohd Yunus, W. M. A., Matinolli, H.-M., Waris, O., Upadhyaya, S., Vuori, M., Korpilahti-Leino, T., Ristkari, T., Koffert, T., & Sourander, A. (2022) · Journal of Medical Internet Research · doi:10.2196/33337 · Cited by 26
“The inclusion and exclusion criteria used to screen the articles were based on PICOS (population, intervention, comparator, outcome, and study design) [38].”
MethodAl-Hammadi, M., Fleyeh, H. A., Åberg, A. C., Halvorsen, K., & Thomas, I. (2024) · Journal of Alzheimer s Disease · doi:10.3233/jad-231459 · Cited by 23
Haftador, A. M., Tehranineshat, B., Keshtkaran, Z., & Mohebbi, Z. (2023) · Journal of Education and Health Promotion · doi:10.4103/jehp.jehp_665_22 · Cited by 32
“The search was carried out within the framework of PICOS (population, intervention, comparison, outcomes and study).[25] “P” represented the students, “I” represented the effects of blended learning and its subcategories on critical thinking (and its subcategories) in students, “C” represented a comparison between the…”
MethodHowlett, N., García-Iglesias, J., Bontoft, C., Breslin, G., Bartington, S., Freethy, I., Malillos, M. H., Jones, J., Lloyd, N., Marshall, T., et al. (2022) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2022.109597 · Cited by 37
“Eligibility criteria for primary study inclusion were determined using the Population-Intervention-Comparator-Outcome-Study design criteria (PICOS; Amir-Behghadami and Janati, 2020).”
MethodDereje, D., Abessa, T. G., Lamba, D., Triccas, L. T., & Bonnechère, B. (2025) · Journal of NeuroEngineering and Rehabilitation · doi:10.1186/s12984-025-01603-1 · Cited by 34
“The study selection process done by using a predefined inclusion criteria based on the Population Intervention Comparison Outcome Study Design (PICOs) method [33].”
Sinurat, S., Karo, M. B., Simbolon, R., Saragih, I. D., Tarihoran, D. E. T. A. U., Sharma, S. D., & Chou, F. (2025) · Nurse Education Today · doi:10.1016/j.nedt.2025.106661 · Cited by 30
Motevalli, M. S. (2025) · International Journal of Clinical Practice · doi:10.1155/ijcp/9929300 · Cited by 25
“It begins with the formulation of the research question and its general criteria, often structured according to the PICO framework (i.e., population, intervention, comparison, and outcome) [21].”
Effect of functional training on fundamental motor skills among children: A systematic review
Zhang, D., Soh, K. G., Chan, Y. M., Feng, X., Bashir, M., & Xiao, W. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e39531 · Cited by 25
Evolution of Chatbots in Nursing Education: Narrative Review
Zhang, F., Liu, X., Wu, W., & Zhu, S. (2024) · JMIR Medical Education · doi:10.2196/54987 · Cited by 34
“The eligibility criteria were devised in accordance with the PICOS (Population, Intervention, Comparison, Outcome, and Study Design) framework [24].”
MethodJohnson, E., Corrick, S., Isley, S., Vandermeer, B., Dolgoy, N., Bates, J., Godfrey, E., Soltys, C., Muir, C., Vohra, S., et al. (2024) · PLOS Digital Health · doi:10.1371/journal.pdig.0000435 · Cited by 24
“Articles retrieved during the searches were screened for relevance; those considered as potentially eligible were evaluated based on the inclusion/exclusion criteria outlined using PICOD [40].”
MethodScotti, K. L., Young, S. M. N., Gainey, M. A., & Lan, H. (2025) · Cochrane Evidence Synthesis and Methods · doi:10.1002/cesm.70046 · Cited by 28
“First, the research team formulates a research question using a framework such as PICO [18] and develops a protocol outlining the research plan.”
Pu, Y., Zhang, G., You, S., Gains, H., Huang, K., Jiao, Y., He, R., Han, B., Yang, H., Jia, Y., et al. (2025) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2025.105085 · Cited by 26
Revolutionizing Bone Regeneration with Grinder-Based Dentin Biomaterial: A Systematic Review
Olchowy, A., Olchowy, C., Zawiślak, I., Matys, J., & Dobrzyński, M. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25179583 · Cited by 24
Does mental fatigue affect performance in racket sports? A systematic review
Ding, C., Soh, K. G., Sun, H., Roslan, S., Cao, S.-D., & Zhao, Y. (2023) · BMC Sports Science, Medicine and Rehabilitation · doi:10.1186/s13102-024-00963-w · Cited by 24
Zhang, Q., Zheng, S., Li, S., Zeng, Y., Chen, L., Li, G., Li, S.-L., He, L.-L., Chen, S.-P., Zheng, X., et al. (2023) · Frontiers in Neurology · doi:10.3389/fneur.2023.1074922 · Cited by 24
“The following eligibility requirements have to be satisfied for an original study to be taken into account in our meta-analysis in accordance with the PICOS recommendation (28).”
Wu, Z.-H., Tang, Y., Tang, M.-W., Wu, Z.-H., & Xu, Y. (2025) · BMC Gastroenterology · doi:10.1186/s12876-025-03886-z · Cited by 23
“Eligibility was based on the PICOS framework [15].”
Lak, M., Shakiba, S., Dolatshahi, B., Saatchi, M., Shahrbaf, M., & Jafarpour, A. (2025) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2025.04.005 · Cited by 24
Zulauf-McCurdy, C. A., McManus, M. S., Golez, M., & Fettig, A. (2024) · SAGE Open · doi:10.1177/21582440241288114 · Cited by 33
“Prior to abstract screening, the authors met to discuss the Population, Intervention, Comparison, Outcomes and Study (PICOS; Amir-Behghadami & Janati, 2020) framework and to determine the criteria for abstract inclusion.”
Cortés-Pérez, I., Moreno-Montilla, L., Ibáñez-Vera, A. J., Díaz-Fernández, Á., Obrero-Gaitán, E., & Lomas-Vega, R. (2024) · Clinical Rehabilitation · doi:10.1177/02692155241253779 · Cited by 23
“The inclusion criteria followed the PICOS criteria 37 : (population) patients with plantar fasciitis; (intervention) extracorporeal shockwaves; (comparator) corticosteroids injections; (outcomes) pain, pain sensitivity, thickness of the plantar fascia and foot function; and (study design) parallel…”
The Role of Immersive Virtual Realities: Enhancing Science Learning in Higher Education
Tene, T., Guevara, M., Moreano, G., Vera, J., & Gomez, C. V. (2024) · Emerging Science Journal · doi:10.28991/esj-2024-sied1-06 · Cited by 23
“As stated, we employ the PICOS approach—a widely recognized research framework for shaping clear and targeted research inquiries in systematic reviews [24].”
Method
Metadata
- Authors
- Amir-Behghadami, M., & Janati, A.
- Affiliations
- Tabriz University of Medical Sciences (IR)
- Venue
- Emergency Medicine Journal
- Publisher
- BMJ
- Published
- 2020-04-05
- Volume
- 37
- Issue
- 6
- Pages
- 387-387
- ISSN
- 1351-0622 (ISSN-L)
- 1472-0205
- 1472-0213
- OpenAlex
- W3015126898
- Cited by
- 1,335
- References
- 0
- Citations by year
- 2026: 408 · 2025: 393 · 2024: 271 · 2023: 148 · 2022: 71 · 2021: 37 · 2020: 5
- FWCI
- 13.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Emergency Medicine Journal (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Health Sciences › Nursing › Research and Theory › Methodologies in Health Research and Practice
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Keywords
- eligibility criteria, systematic review methodology, research design, paracetamol, analgesia
- MeSH terms
- Systematic Reviews as Topic, Humans, Research Design
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