Ask a structured and focused clinical question
This first step is to develop a well-defined question which provides a guide for each stage of the Evidence Based Practice process. Furthermore, asking a clear and focused question assists with the development of keywords and an effective search strategy.
To assist with this step researchers have developed frameworks such as PICO, SPIDER and SPICE. The video below explains how PICO provides a useful framework to formulate a well constructed and answerable research question when investigating the effectiveness of an intervention. Also on this page are examples of the SPIDER and SPICE frameworks. These frameworks may be helpful where your question does not fit into the PICO framework, such as when investigating qualitative studies.
The PICO framework can be used to formulate a question where the review topic is investigating the effect of an intervention or comparing interventions.
The following are frameworks that you can use to help formulate a clear and focused research question, which you can then use to convert into an effective search strategy for your review:
| PICO | for quantitative studies |
|---|---|
| P | Patient, Population or Problem |
| I | Intervention or Exposure |
| C | Comparison |
| O | Outcome |
| Lawani, M. A., Valéra, B., Fortier-Brochu, E., Légaré, F., Carmichael, P. H., Côté, L., ... Giguere, A. M. C. (2017). Five shared decision-making tools in 5 months: use of rapid reviews to develop decision boxes for seniors living with dementia and their caregivers. Systematic Reviews, 6(56), 1-12. doi:10.1186/s13643-017-0446-2.
|
| PICo | for qualitative studies |
|---|---|
| P | Population |
| I | Interest |
| Co | Context |
| SPIDER | for qualitative and mixed methods research studies |
|---|---|
| S | Sample |
| PI | Phenomenon of Interest |
| D | Design |
| E | Evaluation |
| R | Research type |
| Cooke, A., Smith, D., & Booth, A. (2012). Beyond PICO: The SPIDER Tool for Qualitative Evidence Synthesis. Qualitative Health Research, 22(10), 1435–1443. doi:10.1177/1049732312452938. |
| SPICE | for qualitative evidence |
|---|---|
| S | Setting |
| P | Perspective |
| I | Intervention |
| C | Comparison |
| E | Evaluation |
| Harris, J. L. , Booth, A., Cargo, M., Hannes, K., Harden, A., Flemming, K., ... Noyes, J. (2018). Cochrane Qualitative and Implementation Methods Group guidance series—paper 2: methods for question formulation, searching, and protocol development for qualitative evidence synthesis, Journal of Clinical Epidemiology, 97(4), 39-48. doi:10.1016/j.jclinepi.2017.10.023. |
Below are some resources to help with understanding the various study designs you will come across.
Useful resources related to the ASK component