title: PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews.
abstract: BACKGROUND
  Qualitative systematic reviews are increasing in popularity in evidence based health care. Difficulties have been reported in conducting literature searches of qualitative research using the PICO search tool. An alternative search tool, entitled SPIDER, was recently developed for more effective searching of qualitative research, but remained untested beyond its development team.
  
  
  METHODS
  In this article we tested the 'SPIDER' search tool in a systematic narrative review of qualitative literature investigating the health care experiences of people with Multiple Sclerosis. Identical search terms were combined into the PICO or SPIDER search tool and compared across Ovid MEDLINE, Ovid EMBASE and EBSCO CINAHL Plus databases. In addition, we added to this method by comparing initial SPIDER and PICO tools to a modified version of PICO with added qualitative search terms (PICOS).
  
  
  RESULTS
  Results showed a greater number of hits from the PICO searches, in comparison to the SPIDER searches, with greater sensitivity. SPIDER searches showed greatest specificity for every database. The modified PICO demonstrated equal or higher sensitivity than SPIDER searches, and equal or lower specificity than SPIDER searches. The modified PICO demonstrated lower sensitivity and greater specificity than PICO searches.
  
  
  CONCLUSIONS
  The recommendations for practice are therefore to use the PICO tool for a fully comprehensive search but the PICOS tool where time and resources are limited. Based on these limited findings the SPIDER tool would not be recommended due to the risk of not identifying relevant papers, but has potential due to its greater specificity.
authors.affiliation: University of Manchester, Centre for Primary Care, Williamson Building, Oxford Road, Manchester, M13 9PL, UK. abigail.methley@postgrad.manchester.ac.uk.
authors.forename: Abigail M
authors.initials: AM
authors.lastname: Methley
authors.affiliation: University of Manchester, Centre for Primary Care, Williamson Building, Oxford Road, Manchester, M13 9PL, UK. Stephen.Campbell@manchester.ac.uk.|NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Institute of Population Health, The University of Manchester, Manchester, M13 9WL, UK. Stephen.Campbell@manchester.ac.uk.
authors.forename: Stephen
authors.initials: S
authors.lastname: Campbell
authors.affiliation: Institute of Primary Care and Health Sciences, Keele University, Keele, UK. c.a.chew-graham@keele.ac.uk.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Chew-Graham
authors.affiliation: Central Manchester Hospitals Site, Manchester Mental Health and Social Care Trust, Research and Innovation 3rd Floor, Rawnsley Building, Hathersage Road, Manchester, M13 9WL, UK. Rosalind.McNally@mhsc.nhs.uk.
authors.forename: Rosalind
authors.initials: R
authors.lastname: McNally
authors.affiliation: University of Manchester, Centre for Primary Care, Williamson Building, Oxford Road, Manchester, M13 9PL, UK. Sudeh.Cheraghi-sohi@manchester.ac.uk.|NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Institute of Population Health, The University of Manchester, Manchester, M13 9WL, UK. Sudeh.Cheraghi-sohi@manchester.ac.uk.
authors.forename: Sudeh
authors.initials: S
authors.lastname: Cheraghi-Sohi
mesh_terms: D000818:Animals; D016206:Databases, Bibliographic; D006801:Humans; D016247:Information Storage and Retrieval / Q000592:standards*; D015201:Meta-Analysis as Topic; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000628:therapy; D036301:Qualitative Research; D012196:Review Literature as Topic; D057386:Search Engine / Q000592:standards*; D012680:Sensitivity and Specificity