A well-thought-out research question helps set up a research project for success. Researchers can use question development frameworks to craft a well-built question. Development frameworks are guides that take the researcher step by step through the different components that go into building a research question. A researcher with a question in mind can run it through a question development framework to hone their question and sharpen its elements. The process is designed to help highlight the main concepts to focus on. There are many different frameworks; each have their strengths and limitations and are suited to different types of research.
The most common question development framework inquiries seen by Library staff here at CUIMC relate to PICO (Patient/Population, Intervention, Comparison, and Outcome). The popularity of PICO on this campus likely is due to the clinical focus of much of the research done at CUIMC, as PICO is best suited for clinical questions, comparing interventions, and evidence-based medicine. Clinical research is not the only type of research conducted on the CUIMC campus, however. To help researchers select the most appropriate framework for their own work, this article highlights some alternative frameworks in addition to PICO and links to resources on additional frameworks not covered here.
PICO
PICO stands for Patient/Population, Intervention, Comparison, and Outcome. “Patient/population” is the researched group and their distinct characteristics. The “intervention” is the main element (e.g., intervention, prognostic factor, exposure) being studied in this patient/population. The “comparison” is an alternative intervention to be compare to the first. Keep in mind that “comparison” can often be the status quo or a placebo. “Outcome” is what is being measured. “Outcome” can be omitted at this stage in the question development process if it is unknown; this helps the researcher avoid introducing bias during the literature search.
Variations on PICO include PICOT, PICOS, PICOTS, and PICOTTS where T stands for Timeframe and/or Type of study and S for Setting. These variations can be helpful especially if your team is designing a clinical trial. “Timing” can refer to length of the intervention, any follow-up schedule, and the time it takes for outcomes to appear. “Type of study” describes what type of study the research will be (e.g., systematic review, cohort study, randomized control trial). “Setting” looks at where the intervention takes place.
PICO does have some limitations. It privileges interventions and experimental research. If you are interested in learning more about the limitations of PICO, this article from the University of North Carolina at Chapel Hill’s Health Sciences Library is an excellent overview: “Forming Focused Questions with PICO: PICO's Limitations”.
Two tutorials might also help you think about how to use PICO to develop search queries. Embase's tutorial outlines a feature for building a search strategy with PICO. PubMed offers a tutorial called “Using PubMed in Evidence-Based Practice,” which covers using PICO to frame a clinical question and to find search terms.
Example PICO Question
Topic: E-cigarettes and smoking cessation
P: Current smokers ages 18–35
I: E-cigarettes
C: Nicotine patch
O: Smoking cessation
Research question: In adults ages 18–35 who currently smoke, do those that switch to e-cigarettes have a higher likelihood of smoking cessation compared to those that switch to nicotine patches?
PCC
The JBI Manual suggests that the PCC framework is the most appropriate for scoping reviews. This framework can help you write a concise research question and create your scoping review title. PCC stands for Population, Concept, and Context. The "population" refers to the group of people or participants relevant to the review question. The "concept" is the intervention, phenomena, or outcome of interest. The "context" is the specific setting, such as a geographic location.
Example PCC Question
Topic: Adolescent asthma self-management
P: Adolescents aged 13-18
C: Asthma self-management
C: United States
Research question: How do American adolescents aged 13 to 18 self-manage their asthma?
PEO
PEO is a framework for qualitative research questions and represents Population, Exposure, and Outcome(s).
“Exposure” can be exposure to a risk factor, condition, illness, screening, or service. PEO is ideal when researching a potential outcome of a known condition or exposure and looking into correlations.
Example PEO Question
Topic: Mental health and airport noise pollution
P: Adults (over 18 years old) who live within 25 miles from an airport in the United States
E: Noise pollution from airports
O: Self-assessed mental health
Research question: Does noise pollution from airports worsen self-assessed mental health of adults over 18 years old who live within 25 miles from an airport in the United States?
SPIDER
SPIDER is a framework for qualitative or mixed methods research that focuses on samples of populations rather than patients or populations. SPIDER stands for Sample, Phenomenon of Interest, Design, Evaluation, and Research type.
“Sample” is the group of people being studied. “Phenomenon of interest” is the hypothesized reason for behavior or choices. “Design” is the how the study is conceived and run. “Evaluation” is the outcome measure(s), which may be subjective. “Research type” is the methodology being used — qualitative, quantitative, or mixed.
When creating a search string for your literature review, you don’t need to include the Design and Research type, as this could overly restrict the search results. These elements within the framework exist to help you think through your research project and to better inform the project’s inclusion/exclusion criteria.
Example SPIDER Question
Topic: Nursing faculty and library consulting services
S: Nursing faculty at CUIMC who have used the consulting service
PI: Health Science Library’s consulting service's current offerings
D: Interviews
E: Experiences
R: Qualitative
Research question: What are the experiences of nursing faculty who used the Health Science Library’s current consulting service?
SPICE
SPICE is a framework for qualitative research that focuses on evaluating the outcomes of an intervention or project. SPICE represents Setting, Perspective, Intervention/exposure/interest, Comparison, and Evaluation.
“Setting” is where the study takes place. “Perspective” is whose perspective the study focuses on. The “Evaluation” element allows the researcher to define success or focus on a specific measure of an intervention.
Example SPICE Question
Topic: Stress reduction programs held at the Health Sciences Library for Columbia University graduate students
S: Columbia University’s Health Sciences Library space
P: Graduate students
I: Therapy dogs
C: De-stress room
E: Reduced stress levels
Research question: In the Health Sciences Library at Columbia University, do therapy dog sessions reduce the stress levels of graduate students more than the de-stress room?
ECLIPSE
The ECLIPSE framework best fits with qualitative research that examines policy, administration, and management. ECLIPSE stands for Expectation, Client Group, Location, Impact, Professionals, and SErvice. "Expectation" refers to the purpose of the study. The "client group" is the population the service being researched is aiming to serve. The "location" is the setting in which the service's impact will be measured. "Impact" refers to the measurement of change in the service that you are researching. "Professionals" are those providing the service. "Service" is the program or service that is being studied.
Example ECLIPSE Question
Topic: Effectiveness of the outpatient opioid rehabilitation program
E: Outpatient rehabilitation effectiveness
C: Adult opioid users
L: Specific large hospital’s out-patient clinic
I: Number of relapses in a 6-month period post-rehabilitation program
P: Care providers at the out-patient clinic
SE: Rehabilitation and therapy services
Research question: Is the current out-patient opioid rehabilitation program at our hospital reducing the number of relapses in the 6-month period following completion of the program as compared to historical data?
Further Readings
- Booth, A., Noyes, J., Flemming, K., Moore, G., Tunçalp, Ö., & Shakibazadeh, E. (2019). Formulating questions to explore complex interventions within qualitative evidence synthesis. BMJ Global Health, 4(1), e001107. http://dx.doi.org/10.1136/bmjgh-2018-001107
Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Scoping Reviews (2020). Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis. JBI; 2024. https://doi.org/10.46658/JBIMES-24-09
Wildridge, V. (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
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