Sometimes it helps to write an answerable question that begins and ends with a patient, population, or problem. This helps to develop a clinical research and/or EBP question. Using one of the frameworks below for developing searchable and answerable clinical questions can be useful during the research process.
PCC is recommended by JBI to identify the main concepts in your Scoping Review question. Breaking down your question in this way allows you to check for any potentially missed inclusion and exclusion. (Definition from JBI Reviewer's Manual Ch.11)
|
P |
Population, Participants |
Important characteristics of participants including age and other qualifying criteria |
| C | Concept | This guides the scope and breadth of the scoping review. Should include interventions, outcomes and/or phenomena of interest. |
| C | Context | May include cultural factors such as healthcare setting, geographical location, age ranges, gender based interests |
e.g.
|
P |
Population, Participants |
older adults |
| C | Concept | interventions used during COVID-19 lockdown ; safety ; public health |
| C | Context | care home settings |
USING PCC TO INFORM YOUR SCOPING REVIEW QUESTION
What interventions (Concept) were used in care home settings (Context) to ensure older adults (Population) safety during COVID-19 (Concept) : a scoping review
PICO is most widely used in quantitative research questions. Originally designed for questions that include interventions or comparisons which can make it difficult if these elements are not included in your research question.
|
P |
Population, Patient, Problem | Who are the users, patients or community affected? What are their symptoms, age, gender etc. |
| I | Intervention | What is being done for patient/population e.g. screening, surgery, rehabilitation, services etc. |
| C | Comparison | Is there a comparison? e.g different treatment options, placebos etc. |
| O | Outcome | What do you hope to achieve? What changes or measures for patient/population? |
e.g.
|
P |
Population, Patient, Problem | Female patients. |
| I | Intervention | chemotherapy |
| C | Comparison | surgery |
| O | Outcome | better recovery |
USING PICO TO FORM YOUR RESEARCH QUESTION
Is Chemotherapy (intervention) more efficient than Surgery (comparison) in managing stage 1 breast cancer (problem) for women patients (population)?
*Note: It is not necessary to use every element in PICO or to have both a problem and population in your question. PICO is a tool that helps researchers frame an answerable EBP question.
Example article using PICO, PICOS and SPIDER
Similar to PICO with type of Study added. PICOS is most widely used in quantitative research questions. Originally designed for questions that include interventions or comparisons which can make it difficult if these elements are not included in your research question.
| P | Patient, Population, problem | Who are the users, patients or community affected? What are their symptoms, age, gender? |
| I | Intervention | What is being done for patient/population e.g. screening, surgery, rehabilitation, services |
| C | Comparison | Is there a comparison? e.g. different treatment options, placebos etc. |
| O | Outcome | What do you hope to achieve? What changes or measures for patient/population? |
| S | Study design | RCTs? Quantitative studies? This can help reduce irrelevant records |
e.g.
| P | Patient, Population, problem | Female adults with depression |
| I | Intervention | antidepressant medication |
| C | Comparison | exercise |
| O | Outcome | improved quality of life |
| S | Study design | Quantitative studies |
USING PICOS TO FORM YOUR RESEARCH QUESTION
How many adult females with depression (P) have an increased quality of life (O) with regular exercise (C) compared to using antidepressant medication (I)?
Similar to PICO with Time added. PICOT is most widely used in quantitative research questions. Originally designed for questions that include interventions or comparisons which can make it difficult if these elements are not included in your research question.
| P | Population, Patient, Problem | Who are the users, patients or community affected? What are their symptoms, age, gender? |
| I | Intervention | What is being done for patient/population e.g. screening, surgery, rehabilitation, services |
| C | Comparison | Is there a comparison? e.g. different treatment options, placebos etc. |
| O | Outcome | What do you hope to achieve? What changes or measures for patient/population? |
| T | Time | Time describes the duration of your data collection |
e.g.
| P | Population, Patient, Problem | Adults with back pain |
| I | Intervention | physiotherapy |
| C | Comparison | exercise |
| O | Outcome | increase mobility |
| T | Time | Data will be collected daily for 6 weeks |
USING PICOT TO FORM YOUR RESEARCH QUESTION
Does physiotherapy (I) increase mobility (O) in adults with back pain (P) compared to daily exercise (C) at 6 weeks (T)?
PEO is most useful for qualitative research questions.
| P | Patient, Population, Problem | Who are the patients or community being affected? What are their symptoms, age, gender etc? |
| E | Exposure | Is the population exposed to a condition or illness, risk factor, screening, rehabiltation, services? |
| O | Outcomes or themes | patient experiences. Are you looking for improvements in pain, responsiveness to treatment, mobility, quality of life? |
e.g.
| P | Patient, Population, Problem | Adult females using HRT |
| E | Exposure | Breast Cancer |
| O | Outcomes or themes | Daily living, quality of life |
USING PEO TO FORM YOUR RESEARCH QUESTION
Does the quality of life (O) change when women on HRT (P) are diagnosed with breast cancer (E)?
Similar to PEO. PIO is most useful for qualitative research questions
| P | Patient, Population, Problem | Who are the patients or community being affected? What are their symptoms, age, gender etc? | |
| I | Intervention |
|
|
| O | Outcomes or themes | patient experiences. Are you looking for improvements in pain, responsiveness to treatment, mobility, quality of life? |
e.g.
| P | Patient, Population, Problem | adult males smokers |
| I | Intervention | using nicotine patches |
| O | Outcomes or themes | smoking cessation |
USING PIO TO FORM YOUR RESEARCH QUESTION
How effective is nicotine patches (I) in encouraging adult males (P) in smoking cessation (O)?
SPICE is good for formulating questions about qualitative or improvement research. Qualitative research is generally when you want to explore perspectives or opinions about a topic.
| S | Setting | Where? |
| P | Perspective | for Whom? |
| I | Intervention | What? |
| C | Comparison | Compared with what? |
| E | Evaluation | with what Result? |
e.g.
| S | Setting | hospital |
| P | Perspective | children under 19 years of age |
| I | Intervention | allergy testing |
| C | Comparison | community |
| E | Evaluation | improved treatment |
USING SPICE TO FORM YOUR RESEARCH QUESTION
What is the impact of referrals (E) to hospital (S) of offering primary/community (C) allergy testing (I) for children under the age of 19 years old (P)?
SPIDER can be useful for quantitative, qualitative or mixed methodology research questions. This can be used when the research is about attitudes and experiences rather than scientifically measurable data. It involves applying the right criteria to your question by focussing less on the intervention and more on the design of the study, and deals with "samples" rather than a "patient" or "populations". Research questions framed using the SPIDER tool tend to begin with "What are the experiences of ...?"
| S | Sample | The group of participants in qualitative research | |
| PI | Phenomona of interest | The how and why of behaviours and experiences | |
| D | Design | How the study was devised and conducted | |
| E | Evaluation |
|
|
| R | Research type | Qualitative, or quantitative, or mixed? |
e.g.
| S | Sample | First year university students |
| PI | Phenomona of interest | Full time online learning |
| D | Design | Survey |
| E | Evaluation | Experiences |
| R | Research type | Qualitative |
USING SPIDER TO FORM YOUR RESEARCH QUESTION
What are the experiences (E) of first year university students (S) using full time online learning (PI): a qualitative study (R)?
Example article using PICO, PICOS and SPIDER
FINER can be useful for quantitative, qualitative or mixed methodology research questions. FINER allows researchers to ponder the philosophical, logical, and scientific implications of writing research questions. It involves applying the right criteria to your question.
| F | Feasibility | Adequate number of subjects, expertise. Affordable in time and money in manageable scope. |
| I | Interesting | obtaining the answer should be interesting to science/health community |
| N | Novel | should confirm, extend or refute previous findings |
| E | Ethical | amenable to a study that institutional review board would approve |
| R | Relevant | to scientific knowledge, clinical and health policy and future research |