Evidence-based practice: Ask

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Formulating a 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. 


Formulating your research question: PICO method

The PICO framework can be used to formulate a question where the review topic is investigating the effect of an intervention or comparing interventions.

Formulate the research question

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

Rathbone, J., Albarqouni, L., Bakhit, M., Beller, E., Byambasuren, O., Hoffmann, T., … Glasziou, P. (2017). Expediting citation screening using PICo-based title-only screening for identifying studies in scoping searches and rapid reviews. Systematic Reviews, 6(1), 1-7. doi:10.1186/s13643-017-0629-x.

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.


Study designs

Below are some resources to help with understanding the various study designs you will come across.

Further resources

Useful resources related to the ASK component