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Breaking down the question into discrete components can help formulate a good answerable question and also helps in the development of a search strategy.
Well-formulated review questions use a structured format to improve the scientific rigor.
There are various models and frameworks that can be used depending on the nature of the review.
Some of these models and frameworks are shown below.
Type of research question |
Models |
Disciplines |
|---|---|---|
Clinical questions |
PICO Variants - PIO, PICOT, PICOS |
Health |
Quantitative |
PICO & variants PIO, PICOT, PICOS |
Health; Social Sciences
Business & Policy; Environment; Ecology |
Qualitative |
PEO, PICo |
Social Sciences Management |
Mixed Methods
|
PCC |
Health |
Methodology or theory |
BeHEMoTH |
Health |
Further reading:
The PICO model is a tool widely used to develop answerable questions.
Population, Patient or Problem |
Who are the people being studied or What is the problem being looked at? What are their characteristics? |
Intervention |
What is the treatment or intervention being studied? (treat, diagnose, observe) |
Comparison, Control or Comparator |
What is the intervention compared to? (e.g. other interventions, standard treatment, no treatment) This can be optional if no comparison applies. |
Outcome |
What are the relevant outcomes and how are they measured? |
Chapter 5 of the Cochrane Handbook for Systematic Reviews of Interventions has more information on the defining each element of the PICO acronym.
Variants of PICO
PIOUse when there is no Comparison, Control or Comparator |
PICOTIncludes Time from the intervention that outcomes are measured. |
PICOSIncludes Study Design e.g. cohorts or randomized controlled trials. |
Examples
Question:Does the use of chlorhexidine mouthwash prevent gingivitis and aid in plaque control? |
Question:Do first year students who attend the library Orientation week sessions perform better on research assessment than non-attending students? |
Patient, population or problem |
gingivitis and plaque control |
Patient, population or problem |
first year university students | |
Intervention |
use of chlorhexidine mouthwash |
Intervention |
attendance of library orientation sessions | |
Comparison |
those who do not use chlorhexidine mouthwash |
Comparison |
non-attending students | |
Outcome |
decreased gingivitis and increased plaque control |
Outcome |
good assessment results |
Instructional Videos
|
Tutorial from the Cushing/Whitney Medical Library
|
Tutorial from QUT |
SPICE, SPIDER, FINER & PCC are models that can be used for both qualitative and quantitative topics.
SPICE |
|
Setting |
Where is the study being undertaken? |
Perspective |
For whom? Who are the targets or participants of the study? |
Intervention |
What is the change or intervention being studied? |
Comparison |
What is the intervention being compared to? |
Evaluation |
With what result? How is the result being measured? |
Source:Booth, A. (2006). Clear and present questions: Formulating questions for evidence based practice. Library Hi Tech, 24(3), 355-368. https://doi.org/10.1108/07378830610692127
See Example |
|
SPIDER |
|
Sample |
The group of people being looked at |
Phenomenon of Interest |
Looks at the reasons for behaviour and decisions, rather than an intervention. |
Design |
The form of research used, such as interview or survey. |
Evaluation |
The outcome measures. |
Research type |
Type of research. e.g. qualitative, quantitative or mixed method |
Source:Cooke, A., Smith, D., & Booth, A. (2012). Beyond PICO: The SPIDER tool for qualitative evidence synthesis. Qualitative Health Research, 22(10), 1435-1443. https://doi.org/10.1177/1049732312452938
See Example |
|
FINER |
|
Feasibility |
What is the feasibility? Focuses on time, scope, resources, expertise, and funding |
Interesting |
What is the intrinsic and extrinsic interest in answering a research question? |
Novel |
How does it generate new evidence for the current empirical literature? |
Ethical |
What are the ethical implications? |
Relevant |
What is the clinical relevance of a research question? |
Source:Cummings, S. R., Browner, W. S., & Hulley, S. B. (1988) Conceiving the research question. In S. B. Hulley, & S. R. Cummings SR (Eds), Designing Clinical Research. (pp. 12 - 17). Williams & Wilkins
|
|
PCC |
|
Population |
Important characteristics of participants, including age and other qualifying criteria. |
Concept |
Use the ideas from your primary questions to determine your 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". |
Context |
May include... cultural factors such as geographic location and/or specific racial or gender-based interests. In some cases, context may also encompass details about the specific setting |
Source:Aromataris E, Munn Z (Editors). (2020). JBI manual for evidence synthesis. Joanna Briggs Institute. https://doi.org/10.46658/JBIMES-20-01
See Example |
|
The variants of PICO below are adapted to work better with qualitative studies.
PEO |
PICo |
Population and their problems |
Who are the users, patients or community being affected? What are their symptoms, age, gender etc. |
Population |
What are the characteristics of the population or patient? What condition or disease are you interested in? |
|
Exposure |
Use for a specific exposure (this term is used loosely) such as “witnessed resuscitation” or “domestic violence” |
Interest |
The phenomena of interest, related to a defined event, activity, experience or process |
|
Outcomes or themes |
Are you looking for improvements in pain, responsiveness to treatment, mobility, quality of life, daily living? Usually there will be an element of looking at patient’s experiences. |
Context |
The setting or distinct characteristics
|
Source:Moola, S., Munn, Z., Sears, K., Sfetcu, R., Currie, M., Lisy, K., . . . Mu, P. (2015). Conducting systematic reviews of association (etiology): The Joanna Briggs Institute's approach. International Journal of Evidence-Based Healthcare, 13(3), 163-169. https://doi.org/10.1097/XEB.0000000000000064
|
Source:Lockwood, C., Munn, Z., & Porritt, K. (2015). Qualitative research synthesis: Methodological guidance for systematic reviewers utilizing meta-aggregation. International Journal of Evidence-Based Healthcare, 13(3), 179-187. https://doi.org/10.1097/XEB.0000000000000062
|
|
CLIP & ECLIPSE are other types of question frameworks for qualitative studies |
CLIP |
ECLIPSE |
Client group |
At whom is the service aimed? |
Expectation |
What do you want the information for (the original ‘I’s)? | |
Location |
Where is the service sited? |
Client group |
At whom is the service aimed? | |
Improvement or Information or
|
What do you want to find out? |
Location |
Where is the service sited? | |
Professionals |
who is involved in providing/improving the service? |
Impact |
What is the change in the service, if any, which is being looked for? What would constitute success? How is this being measured? | |
Professionals |
Who is involved in providing/improving the service? | |||
Service |
Which service are you looking for information? For example, outpatient services, nurse‐led clinics, intermediate care. |
Source:Wildridge, V., & Bell, L. (2002). How CLIP became ECLIPSE: A mnemonic to assist in searching for health policy/management information. Health Information and Libraries Journal, 19(2), 113-115. https://doi.org/10.1046/j.1471-1842.2002.00378.x
|
PICO |
PIFT |
P |
Population, Problem or Patient |
Product or Process |
What is the product or process category being assessed? | |
I |
Intervention |
Impacts |
What are the impact(s) of interest? | |
C |
Comparison, Control or Comparator |
Flows |
What are the flow(s) or economic sectors contributing to the impact? |
|
O |
Outcome |
Types |
What are the types of Life Cycle Assessment of interest? |
Source:Zumsteg, J. M., Cooper, J. S., & Noon, M. S. (2012). Systematic review checklist: A standardized technique for assessing and reporting reviews of life cycle assessment data. Designing Journal of Industrial Ecology, 16 (S1), S12-S21. https://doi.org/10.1111/j.1530-9290.2012.00476.x
|
BeHEMoTh |
SDMO |
Be |
Behaviour of interest |
S |
Types of studies | |
H |
Health context |
D |
Types of Data | |
E |
Exclusions |
M |
Types of Methods | |
MoTh |
Models or Theories |
O |
Types of Outcome measures |
Source:Booth, C., & Carroll, C. (2015). Systematic searching for theory to inform systematic reviews: is it feasible? Is it desirable? Health Information & Libraries Journal, 32(3), 220-235. https://doi.org/10.1111/hir.12108
|
Source:Clarke, M., Oxman, A. D., Paulsen, E., Higgins, J. P., Green, S. (2011). Appendix A: Guide to the contents of a Cochrane Methodology protocol and review. In: J. P. Higgins & S. Green (Eds.). Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). The Cochrane Collaboration. |
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