Develop a Research Question
At this stage in the process, you and your team have identified a knowledge gap in your field and are aiming to answer a specific question. Next, you will develop your research question. Developing your research question is one of the most important steps in the evidence synthesis process.
Formulating a clear, well-defined research question of appropriate scope is key to a successful evidence synthesis. The research question will be the foundation of your synthesis and from it your research team will identify 2-5 possible search concepts. These search concepts will later be used to build your search strategy.
Use a framework to structure your research question by clarifying the main concepts of your topic you want to focus on. Your topic may not fit perfectly into a framework, just using part of a framework can be sufficient.
The framework you should use depends on the type of topic you will be researching.
The most common frameworks are:
Please view the chart below for more information.
Source: Frameworks reproduced and modified with gratitude from the University of London: Using a framework to structure your question Research Guide.
Identify the PICO elements
(P) Patient, Population or Problem - This may include the primary problem, disease, or existing conditions. Sometimes the gender, age, or race of a patient may be relevant to the diagnosis or treatment of a disease.
(I) Intervention - Which main intervention, prognostic factor, or exposure are you considering? Or what factor may influence the prognosis of the patient - age, co-existing problems, or previous exposure?
(C) Comparison - What is the main alternative to compare with the intervention?
(O) Outcomes - What are you hoping to accomplish, improve or affect?
Example: Amongst children how does alternative therapies compare to pain medication for controlling headaches?
P - Children
I - Alternatives to drugs (complementary therapies? changes to lifestyle?)
C - Pain medication
O - Controlling headaches
There are extensions to the PICO framework available which you can use if your topic has additional concepts:
PICOS- S stands for study designs. Use framework if you are only interested in examining specific designs of study.
PICOT- T stands for timeframe. Use framework if your outcomes need to be measured in a certain amount of time - e.g. 24 hours after surgery.
PICOC- C stands for context. Use this framework if you are focusing on a particular organization or particular circumstances.
Source: Frameworks reproduced and modified with gratitude from the University of London: Using a framework to structure your question Research Guide.
Identify the PICo elements
(P) Patient, Population or Problem- Who and/or what is my question focussed on?
(I) Interest - A defined event, experience, activity or process.
(Co) Context - A setting or distinct characteristics.
Example: What are the experiences of patients with pressure sores who receive treatment at home?
P - Patients with pressure sores
I - Experiences, views, opinions
Co - Care in the home
Identify the PEO elements
(P) Population - who is my question focussed on?
(E) Exposure - what is the issue I'm interested in?
(O) Outcomes or themes - what, in relation to the issue, do I want to examine?
Example: The daily living experiences of mothers with postnatal depression
P- mothers
E- postnatal depression
O- experiences of daily living/quality of life
Identify the SPICE elements
(S) Setting - Where is the study set e.g. in a specific country, community, in a hospital, in a care home etc.
(P) Perspective - From whose perspective is the study done e.g. the patients, the health professionals., the carers etc.
(I) Intervention - What intervention is being examined?
(C) Comparison - Is the intervention being compared with another?
(E) Evaluation - The outcome measures
Example: Amongst those living in long term facilities, what are the attitudes of carers of people with dementia towards reminiscence therapy?
S - long term care facilities
P - carers
I - reminiscence therapy
C - NONE
E - attitudes
Identify the SPICER elements
(S) Sample - the group of people being looked at, because qualitative research is not easy to generalize, sample is preferred over patient.
(PI) Phenomenon of Interest - reasons for behaviour and decisions, rather than an intervention.
(D) Design - the form of research used, such as interview or survey.
(E) Evaluation - outcome measures.
(R) Research type - qualitative, quantitative and/or mixed methods.
Example: What are the experiences of first time parents attending antenatal classes at Island Health?
S - First time parents
PI - Attendance at ante-natal education classes
D - Interviews
E - Experiences
R - Qualitative studies
Identify the elements of CLIP
(C) Client – who is the service aimed at?
(L) Location – where is the service sited?
(I) Improvement – what do you want to find out?
(P) Professional – who is involved in providing/improving the service?
Example: How can the clinic improve delivery of tele-health services to elderly patients in rural communities?
C - Elderly patients
L - Rural communities
I - How services can be improved
P - Tele-health professionals
Identify the elements of ECLIPS(E)
(E) Expectation - What is the information needed for?
(C) Client Group - Who is the information needed for e.g. health managers, GPs, patients
(L) Location - Where is the client group or service located
(I) Impact - What is the change in the service, if any, which is being looked for? What would constitute success? How is this being measured?
(P) Professionals - What health professionals are involved in the service?
(S) Service - For which service are you looking for information? For example, outpatient services, nurse-led clinics, intermediate care.
Example: Amongst medical students, what is the retention of female students?
E- To find out retention rates
C- School administrators
L- UBC
I- Retention of female students
P- Medical students
S- Physicians
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