Introduction Conducting Cochrane reviews and updating them regularly requires a considerable investment from authors and the editorial base alike. It is therefore important that the reviews that are eventually published provide the most informative answers to the most relevant questions to guide decision-making. Asking vague questions leads to vague answers and is a waste of time, money and resources.

Methods Any question arising from practice that has to do with choosing a suitable intervention for a particular health issue can be formulated to contain the elements p=Participants, I=Intervention(s), C=Control and O=Outcome(s). Similarly, a research study evaluating the effectiveness of a particular intervention and a systematic review aiming to make a summary of all sufficiently similar studies ought to use this recipe. This talk will explore how each of these elements influence the whole review process from searching studies to making a synthesis of their findings and reporting results.

Result We will compare a convenience sample of five recent Cochrane Work reviews with another five recent non-Cochrane reviews for their use of PICO and how it is implemented throughout the review.

Discussion PICO is a simple tool that will ensure that research will answer the question of interest that has arisen from practice. Ignoring PICO almost certainly leads to a biassed review process and consequently biassed review results. PICO is the most important ingredient in enabling evidence-based medicine.