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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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Systematic Reviews: Are They Actually Well Conducted and Reported in Accordance with PRISMA?
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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
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“28 There will be no limitations on language or publication year.”
BackgroundKanan, M., Abdulrahman, S., Alshehri, A., Alsuhaibani, R., Alotaibi, N. M., Alsaleh, A., Nasser, B., Baowaydhan, R., Alredaini, I., Khalid, T., et al. (2024) · JMIR Research Protocols · doi:10.2196/54680 · Cited by 2
“…(Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines [25,26] and will be structured according to the PICOS (Population, Intervention, Comparison, Outcomes, and Study) criteria for comprehensive and transparent reporting [27], as given in Textbox 1 and Table 1.”
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“The search and modifications to the protocol aligned with Population, Intervention, Comparator, Outcome, Study design (PICOS) criteria [32] to investigate the research question.”
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“The third phase involves the systematic exclusion of papers irrelevant to the research questions, guided by the PICOS framework [16].”
MethodFamilial congenital laryngotracheal stenosis: A systematic review.
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“The following PICOS (Population, Intervention, Comparator, Outcome, and Study Design) framework [26] will be considered to determine the eligibility of studies (Table 1).”
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“The PICOS model (population, intervention, comparison, outcomes, study design) [11] was used to design this review: (1) studies that considered patients (population) with uterine LMS spinal bone metastasis submitted to, (2) spinal surgery (interventions), (3) without a comparison group (comparisons), (4) that reported…”
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“Eligibility criteria Inclusion and exclusion criteria After a thorough investigation of the existing pieces of evidence under the topic, the study was carried out based on the framework of PICOS (Population, Intervention, Control, Outcome, and Study design) with aim of achieving easy, and clear stages [45].”
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“Criteria for included studies based on PICOS structure (Table 1) (12).”
MethodMousaloo, A., Amir-Behghadami, M., Janati, A., & Gholizadeh, M. (2021) · Systematic Reviews · doi:10.1186/s13643-021-01657-x · Cited by 2
“It has been developed as a substitute for population, intervention, comparison, outcome, and study type (PICOS) [19] in order to optimize identification of qualitative review question.”
MethodInfluentialSelf-citationAmir‐Behghadami, M., Janati, A., & Gholizadeh, M. (2020) · Archives of Public Health · doi:10.1186/s13690-020-00417-y · Cited by 1
Self-citationIn reply:PICO questions in systematic reviews
Ridderikhof, M., & Hollmann, M. (2020) · Emergency Medicine Journal · doi:10.1136/emermed-2020-209587 · Cited by 2
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“The Author's background, research method, interest issues, comparisons, article conclusions are used to establish inclusion criteria [31].”
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“The eligibility criteria were defined according to the PICO framework [14].”
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“Eligibility criteria were developed using the PICoS framework recommended by the Joanna Briggs Institute (JBI) [15]”
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“To ensure a rigorous selection process, inclusion and exclusion criteria were established utilizing the PICOS strategy (10).”
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“Studies were selected based on the PICOS framework [12].”
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“Table 1 Population, intervention, comparison, outcome, settings (PICOS) criteria [10] applied to the present review.”
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“Studies were included according to the PICOS framework [35]: (1) patients of any age who had undergone primary ACLR surgery with no ligament injuries in contralateral knee; (2) interventions involving different tendon autografts for ACLR; (3) comparisons between different tendon autografts; (4)…”
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“Study selection was guided by the PICOS components, including population characteristics, intervention type, comparison conditions, outcome measures, and design features [20].”
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“Study selection was based on prede fi ned PICOS criteria (18).”
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“The PICOS framework—commonly used in systematic reviews to structure research questions and define the eligibility criteria population (P), intervention (I), comparison (C) and outcome (O), and study design (S) (9, 10) —was adapted for this review, as no interventions or comparators were applicable.”
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“Eligibility criteria were defined according to the PICOS framework [24].”
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“The eligibility criteria were defined using the PICOS framework [11].”
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“Eligibility criteria were defined according to the PICOS framework to ensure consistent and systematic selection of relevant studies for inclusion in our study [21].”
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“The review applied the following population, intervention, comparison, outcomes, and study design (PICOS)-based inclusion criteria (Amir-Behghadami and Janati 2020), as Table 3 shows.”
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“The eligibility criteria for study inclusion were defined using the PICOS framework to ensure clarity and consistency [9].”
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“The eligibility criteria for study selection were defined using the Population, Intervention, Comparison, Outcomes, and Study design (PICOS) framework [9].”
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“The study selection was carried out following the PICOS (Population, Intervention, Comparison, Outcomes, and Study Design) theme [21].”
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“A PICO (Population, Intervention, Comparison, and Outcome) framework was employed to formulate a focused research question and to define the inclusion and exclusion criteria for the present study (13).”
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Peter, W. S., Neumiller, J., Alicic, R. Z., Chow, S., Dowell, H., Duru, O., Gee, P., Mathew, R. O., Nicholas, S. B., Rangaswami, J., et al. (2026) · Journal of the American College of Clinical Pharmacy · doi:10.1002/jac5.70198 · Cited by 1
“Included studies were defined according to the PICOS (population, intervention, comparator, outcome, study type and setting) framework [22] using the eligibility criteria outlined in Table 1.”
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“The PICOS framework (Population, Intervention, Comparison, Outcomes, and Study Design) was used to develop the inclusion criteria [28].”
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“Eligibility criteria were defined using the PICOS framework [13].”
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“The research focus was operationalized using the PICOS framework (Population, Intervention, Comparison, Outcomes, Study Design), which provided a structured conceptual foundation for defining inclusion criteria and developing search strategies (Amir-Behghadami & Janati, 2020; Frandsen et al., 2020).”
Quan, Z., Song, W., Huang, Q., & Wang, J. (2026) · Frontiers in Immunology · doi:10.3389/fimmu.2026.1730624 · Cited by 2
Che, L.-L., Dong, W., Liu, Y., & Guo, H. (2026) · Frontiers in Pharmacology · doi:10.3389/fphar.2026.1693378 · Cited by 1
Effectiveness of Nurse‐Led Community Resilience Building Interventions: A Systematic Review
Fitri, P. N., & Saifudin, I. (2026) · Public Health Nursing · doi:10.1111/phn.70083 · Cited by 1
Nunes, G. S., Pellenz, M. M., Piussi, J. B., Wageck, B., Signori, L. U., Solner, M. W., & Dangui, A. J. M. (2026) · The Knee · doi:10.1016/j.knee.2026.104358 · Cited by 2
Dávila, E. O. P., Neder‐Suárez, D., Legleu, C. E. C., Hernández‐Torres, R. P., Carreño, R. E. A., & Benítez-Hernández, Z. P. (2026) · Nutrition and Health · doi:10.1177/02601060261416845 · Cited by 2
“We de fi ned the inclusion criteria based on the PICOS model (Amir-Behghadami and Janati, 2020).”
The Effect of the Rebozo Technique on the Length of the First Stage in Vaginal Labor
Habibah, P., & Arlym, L. T. (2026) · Journal La Medihealtico · doi:10.37899/journallamedihealtico.v7i1.2860 · Cited by 1
“Article inclusion criteria for systematic reviews using PICOS include population, intervention, comparator, outcome, and study design (Amir-Behghadami & Janati, 2020).”
Akwaronwu, B. G., Ayankoya, F., Kuyoro, S., Akwaronwu, I. U., & Adeniyi, O. (2026) · Big Data Mining and Analytics · doi:10.26599/bdma.2025.9020063 · Cited by 1
EFFECTIVENESS OF DISINFECTION METHODS FOR TOOTHBRUSHES: A SYSTEMATIC REVIEW AND META-ANALYSIS
Li, J., LIU, Q., Liang, Z., Li, K. Y., Xing, X., Lin, L., Peng, S., Yiu, C. K. Y., & Wong, H. M. (2026) · Journal of Evidence Based Dental Practice · doi:10.1016/j.jebdp.2026.102239 · Cited by 3
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Bello, F. D., on Behalf of EAU - YAU Kidney transplant working group, Gallioli, A., Pecoraro, A., Prudhomme, T., Piana, A., Marco, B. B., Haberal, H. B., Dönmez, M. İ., López‐Abad, A., et al. (2026) · Minerva Urology and Nephrology · doi:10.23736/s2724-6051.25.06559-0 · Cited by 1
Dallı, Ö. E., & Pehli̇van, S. (2026) · BMC Medical Education · doi:10.1186/s12909-026-08693-y · Cited by 1
“This structured approach ensured a transparent and rigorous process for selecting studies relevant to the meta-analysis objectives [21].”
Sacchini, F., Biondini, F., Cangelosi, G., Palomares, S. M., Mancin, S., Parozzi, M., Caggianelli, G., Russotto, S., Masini, A., Lopane, D., et al. (2026) · Psychiatry International · doi:10.3390/psychiatryint7010024 · Cited by 1
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“Prior to the literature screening process, predefined inclu - sion and exclusion criteria were established according to the PICOS framework [ 13].”
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“The selection of studies included in this systematic review was based on predefined inclusion and exclusion criteria, structured according to the PICOS (Patient/Problem, Inter-vention or Treatment, Comparative Intervention, Outcomes) model [38].”
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“The predefined criteria used to evaluate study eligibility were founded on the Population, Intervention, Comparison, Outcome, and Study design (PICOS) framework (Amir-Behghadami and Janati, 2020; Higgins et al., 2024).”
Pehli̇van, S., & Dallı, Ö. E. (2026) · BMC Medical Education · doi:10.1186/s12909-025-08537-1 · Cited by 1
“This structured approach ensured a transparent and rigorous process for selecting studies relevant to the review objectives [27].”
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“…and outcomes led by incidence of nerve injury, with secondary outcomes including mechanisms, functional recovery and time to recovery, voice and swallowing metrics, neurosensory measures, shoulder function, complications, quality of life, neuropathic pain, and prevention effectiveness [16].”
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“Studies were considered for inclusion based on the following Population-Intervention-Comparator-Outcomes-Study Design (PICOS) framework (26): (P) adults with upper-Highlight”
Sarmiento-Rojas, J. A., Güiza-Pinzón, F.-D., Alarcon, J. J., Quiroga, E. L. B., & Garzón-Agudelo, D.-M. (2025) · Revista Hábitat Sustentable · doi:10.22320/07190700.2025.15.02.04 · Cited by 3
Therapeutic efficacy of quercetin in experimental pulmonary fibrosis: A meta-analysis
Cai, L., Chen, L., & Lin, C. (2025) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2025.13054 · Cited by 1
“Following the population, intervention, comparison, outcomes and study (PICOS) framework (13), the search strategy was designed using the keywords ‘quercetin’ and ‘pulmonary fibrosis’, including both subject headings and free terms.”
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Meireles, A., Nunes, R. D. A. M., da Silva, G. C. P. S. M., Silva, Y. R., Sodré, R. D. S., Lopes, G. C., da Silva, J. D., & Vale, R. G. D. S. (2025) · International Journal of Sports Science & Coaching · doi:10.1177/17479541251400753 · Cited by 1
“The inclusion criteria for the studies in this review were out-lined based on the PICOS strategy, 16 where: the population (P) consists of athletes and trained individuals aged 18 years or older; the intervention (I) involves resistance training with optimum power load; the comparison (C) is with…”
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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