What is the roblem, condition or disease you are interested in?
How do you wish to ntervene? What do you want to do with this patient - treat, diagnose, observe, etc.? | What is the omparison or alternative to the intervention - placebo, different drug or therapy, surgery, etc.? | What are the possible utcomes - morbidity, death, complications, etc.? | Here is an example of a clinical question that outlines the PICO components:
![pico research question systematic review pico research question systematic review](https://libapps-au.s3-ap-southeast-2.amazonaws.com/accounts/46445/images/SR_-_PICO_eg1.jpg)
PICo for qualitative studies
P | I | Co |
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What are the characteristics of the opulation or atient? What is the roblem, condition or disease you are interested in? | nterest relates to a defined event, activity, experience or process | ntext is the setting or distinct characteristics |
Here is an example of a clinical question that outlines the PICo components:
![pico research question systematic review pico research question systematic review](https://libapps-au.s3-ap-southeast-2.amazonaws.com/accounts/46419/images/SR_-_PICo_eg2.JPG)
Two other mnemonics may be used to frame questions for qualitative and quantitative studies - SPIDER and SPICE .
SPIDER for qualitative or quantitative studies
SPIDER can be used for both qualitative and quantitative studies:
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ample size may vary in quantitative and qualitative studies | henomena of nterest include behaviours, experiences and interventions | esign influences the strength of the study analysis and findings | valuation outcomes may include more subjective outcomes such as views, attitudes, etc. | esearch types include qualitative, quantitative, or mixed-method studies |
Within social sciences research, SPICE may be more appropriate for formulating research questions:
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etting is the context for the question - | erspective is the users, potential users or stakeholders of the service - | ntervention is the action taken for the users, potential users or stakeholders - | omparison is the alternative actions or outcomes - | valuation is the result or measurement that will determine the success of the intervention - or |
More question frameworks
For more question frameworks, see the following:
- Table 1 Types of reviews , from ' What kind of systematic review should I conduct? A proposed typology and guidance for systematic reviewers in the medical and health sciences. '
- Framing your research question , CQ University
- Asking focused questions - Centre for Evidence Based Medicine Tips and examples for formulating focused questions
- Cochrane Handbook, Chapter 2: Determining the scope of the review and the questions it will address Discusses the formulation of review questions in detail
- PICO for Evidence-Based Veterinary Medicine EBVM Toolkit from the RCVS
- PICO worksheet
- PICo worksheet
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Systematic Reviews
- Introduction to Systematic Reviews
- Systematic review
- Systematic literature review
- Scoping review
- Rapid evidence assessment / review
- Evidence and gap mapping exercise
- Meta-analysis
- Systematic Reviews in Science and Engineering
- Timescales and processes
- Question frameworks (e.g PICO)
- Inclusion and exclusion criteria
- Using grey literature
- Search Strategy This link opens in a new window
- Subject heading searching (e.g MeSH)
- Database video & help guides This link opens in a new window
- Documenting your search and results
- Data management
- How the library can help
- Systematic reviews A to Z
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Using a framework to structure your research question
Your systematic review or systematic literature review will be defined by your research question. A well formulated question will help:
- Frame your entire research process
- Determine the scope of your review
- Provide a focus for your searches
- Help you identify key concepts
- Guide the selection of your papers
There are different models you can use to structure help structure a question, which will help with searching.
Selecting a framework
- What if my topic doesn't fit a framework?
A model commonly used for clinical and healthcare related questions, often, although not exclusively, used for searching for quantitively designed studies.
Example question: Does handwashing reduce hospital acquired infections in elderly people?
| opulation | Any characteristic that define your patient or population group. | Elderly people |
| ntervention | What do you want to do with the patient or population? | Handwashing |
| omparison (if relevant) | What are the alternatives to the main intervention? | No handwashing |
| utcome | Any specific outcomes or effects of your intervention. | Reduced infection |
Richardson, W.S., Wilson, M.C, Nishikawa, J. and Hayward, R.S.A. (1995) 'The well-built clinical question: a key to evidence-based decisions.' ACP Journal Club , 123(3) pp. A12
PEO is useful for qualitative research questions.
Example question: How does substance dependence addiction play a role in homelessness?
| Who are the users - patients, family, practitioners or community being affected? What are the symptoms, condition, health status, age, gender, ethnicity? What is the setting e.g. acute care, community, mental health? | homeless persons |
| Exposure to a condition or illness, a risk factor (e.g. smoking), screening, rehabilitation, service etc. | drug and alcohol addiction services |
| Experiences, attitudes, feelings, improvement in condition, mobility, responsiveness to treatment, care, quality of life or daily living. | reduced homelessness |
Moola S, Munn Z, Sears K, Sfetcu R, Currie M, Lisy K, Tufanaru C, Qureshi R, Mattis P & Mu P. (2015) 'Conducting systematic reviews of association (etiology): The Joanna Briggs Institute's approach'. International Journal of Evidence - Based Healthcare, 13(3), pp. 163-9. Available at: 10.1097/XEB.0000000000000064.
PCC is useful for both qualitative and quantitative (mixed methods) topics, and is commonly used in scoping reviews.
Example question: “What patient-led models of care are used to manage chronic disease in high income countries?"
Population | "Important characteristics of participants, including age and other qualifying criteria. You may not need to include this element unless your question focuses on a specific condition or cohort." | N/A. As our example considers chronic diseases broadly, not a specific condition/population - such as women with chronic obstructive pulmonary disorder. |
Concept | "The core concept examined by the scoping review should be clearly articulated to guide the scope and breadth of the inquiry. This may include details that pertain to elements that would be detailed in a standard systematic review, such as the "interventions" and/or "phenomena of interest" and/or "outcomes". | Chronic disease Patient-led care models Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis, JBI, 2020. Available from https://synthesismanual.jbi.global . https://doi.org/10.46658/JBIMES-20-12 A model useful for qualitative and mixed method type research questions. Example question: What are young parents’ experiences of attending antenatal education? (Cooke et al., 2012) | ample | The group you are focusing on. | Young parents | | henomenon of nterest | The behaviour or experience your research is examining. | Experience of antenatal classes | | esign | How the research will be carried out? | Interviews, questionnaires | | valuation | What are the outcomes you are measuring? | Experiences and views | | esearch type | What is the research type you are undertaking? | Qualitative | Cooke, A., Smith, D. and Booth, A. (2012) 'Beyond PICO: the SPIDER tool for qualitative evidence synthesis.' Qualitative Health Research , 22(10) pp. 1435-1443 A model useful for qualitative and mixed method type research questions. Example question: How effective is mindfulness used as a cognitive therapy in a counseling service in improving the attitudes of patients diagnosed with cancer? | etting | The setting or the context | Counseling service | | opulation or perspective | Which population or perspective will the research be conducted for/from | Patients diagnosed with cancer | | ntervention | The intervention been studied | Mindfulness based cognitive therapy | | omparison | Is there a comparison to be made? | No comparison | | valuation | How well did the intervention work, what were the results? | Assess patients attitudes to see if the intervention improved their quality of life | Example question taken from: Tate, KJ., Newbury-Birch, D., and McGeechan, GJ. (2018) ‘A systematic review of qualitative evidence of cancer patients’ attitudes to mindfulness.’ European Journal of Cancer Care , 27(2) pp. 1 – 10. A model useful for qualitative and mixed method type research questions, especially for question examining particular services or professions. Example question: Cross service communication in supporting adults with learning difficulties | xpectation | Purpose of the study - what are you trying to achieve? | How communication can be improved between services to create better care | | lient group | Which group are you focusing on? | Adult with learning difficulties | | ocation | Where is that group based? | Community | | mpact | If your research is looking for service improvement, what is this and how is it being measured? | Better support services for adults with learning difficulties through joined up, cross-service working | | rofessionals | What professional staff are involved? | Community nurses, social workers, carers | | ervice | Which service are you focusing on? | Adult support services | You might find that your topic does not always fall into one of the models listed on this page. You can always modify a model to make it work for your topic, and either remove or incorporate additional elements. The important thing is to ensure that you have a high quality question that can be separated into its component parts. - << Previous: Timescales and processes
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