Modifying “Pico” Question into “Picos” Model for More Robust and Reproducible Presentation of the Methodology Employed in A Scientific Study

The mnemonic “PICO” was originally coined to help guide a standardized and disciplined way of formulating a clinical research question, carrying out a thorough literature search to answer that question (particularly through the MEDLINE/PubMed) and resultantly generate a fulfilling and all encompassing evidencebased answer to the constructed clinical query. The elements of the PICO question included “P” for problem or patient or population, “I” for intervention or exposure, “C” for comparison and “O” for outcomes. The PICO question was recommended to be phrased into appropriate search strings to find out all the relevant published quality literature available on the cyberspace.1-3 The PICO framework is absolutely laudable for the purpose for which it was originally introduced. We modify it into PICOS model to further extend its scientific utility for the logical and thorough description of the methodology part of the scientific manuscripts. We include “S” for representing an equally important component of the research exercise. i.e. the statistical analyses employed for analyzing the data obtained from the study and the subsequent conclusions inferred there from. The advocated addition of “S” to the mnemonic PICO modifies it into PICOS, ensuring reproducibility and more robust expression of the study protocol followed in any particular scientific research.1-3 The crucial concept of statistical analyses in research studies is well established, however quite often researchers are unaware of its significance and logical implications. Resultantly their reported studies suffer the lack of robust reproducibility and translation to the general population at large.4,5 The proposed PICOS approach is intended to serve as a guide for the authors and help them efficiently and thoroughly describe their research methodology while reporting their original studies. Additionally it will also serve as a checklist guide for the reviewers and editors to more thoroughly review the manuscripts under their evaluation and hence ensure their scientific validity and statistical robustness. By ensuring uniform methodological standards and objectivity, the overall scientific value of the published literature will certainly enhance.4,5 Following is a brief summary of the proposed PICOS model for describing the methodology employed in any research pursuit: P---Patient population: The patients or subjects who were studied in the research pursuit are specifically highlighted. This Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad, 44000, Pakistan