The P in PICO describes the main characteristics of the participants in a study (sex, age range and condition). When annotating the Population or Participants it is important to consider the question that is the focus of the review. This is the population group that the intervention will directly affect.
Use this term if the authors have stated 'Healthy People' i.e. those who are being assessed for prevention of or at risk of diseases
Prevention and Risk
Some reviews look at the prevention of or at risk of a condition. In this case the condition field is left blank will likely be annotated as an outcome.
CD
Topic
Annotation
CD010518
Massage therapy for preventing pressure ulcers
Population field is empty
Pressure ulcers is an Outcome
"Preventive" can be added as an Rationale modifier to Massage Therapy in the Intervention section. Click HERE for more info.
CD009551
At risk of invasive aspergillosis
Invasive aspergillosis would be an outcome
Two different populations
The Population of a review or study sometimes contains two different populations (e.g. parent and child, patient and provider, student and teacher, etc.)
The P section in our annotations is set up with the assumption that each P would reflect a single homogeneous group of individuals
If P is not clear check the interventions, comparisons or outcomes to determine who is the target of the intervention, or will have outcome measurements performed
Populations
Description
How to annotate
Pregnant women
During pregnancy, any intervention delivered to the mother has the potential to affect the fetus
Some authors will reflect this by stating "pregnant women and their unborn children" or some similar formulation as the P
Some of these reviews or studies will measure outcomes in both mothers and fetus
In most cases it is safe to include only information about the mother in the P and allow the Pregnancy part of the annotation to indicate that a fetus is also involved
Indirect interventions
In some studies an intervention directed at one group is intended to have an impact on a different group and authors include both the target and the vector in their description of P
The target of the intervention should be used as the P and the group through which the intervention is delivered can be left un-annotated
Study design
Information about how study subjects were recruited is sometimes included but may look like 2 Ps rather than one
A study that asked physicians to recruit patients might list the P as "patients with X and their physicians"
Do not annotate the physician if their only role was recruitment as they will not be the target of the interventions or have outcome measurements performed
CD number
Title
Types of participants
Notes
CD010385
Strategies of testing for syphilis during pregnancy
Eligible participants were either pregnant women at any stage of their pregnancy or healthcare facilities/clinics depending on the randomisation unit in each of the included trials
Who is the intervention directed towards? Clearly the pregnant women were the P, because healthcare facilities/clinics never get antenatal syphilis screening tests.
So the healthcare facilities/clinics part can be ignored in the annotation.
Two populations
Some studies or reviews look at intervention effects in two or more populations
Use OR
Sex (gender)
Annotate the specific sex stated in the review
If none is is stated select male and female except where it may be obvious that the sex is one or the other, e.g. Pregnancy.
Age
The age groupings have been taken from MeSH
Some groupings may not reflect precisely the specific age group stated in the review e.g. authors may state adults from 20 to 35 years of age for which the annotator would need to select Adult 19-44
Adolescent is listed under 'Child'. Under Adult we have Young Adult Years (19-24) and Adult (19-44)
A number of studies will state in their inclusion criteria Aged 18 years or older. Please annotate as Adult & Aged (or select the specific group(s) within each category) as required.