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Systematic Reviews: Formulating Your Research Question

A Guide to Conducting Systematic Reviews

Types of Questions

Research questions should be answerable and also fill important gaps in the knowledge. Developing a good question takes time and may not fit in the traditional framework.  Questions can be broad or narrow and there are advantages and disadvantages to each type. 

Questions can be about interventions, diagnosis, screening, measuring, patients/student/customer experiences, or even management strategies. They can also be about policies. As the field of systematic reviews grow, more and more people in humanities and social sciences are embracing systematic reviews and creating questions that fit within their fields of practice. 

More information can be found here:

Thomas J, Kneale D, McKenzie JE, Brennan SE, Bhaumik S. Chapter 2: Determining the scope of the review and the questions it will address. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Cochrane, 2019. Available from www.training.cochrane.org/handbook.

Frameworks

Frameworks are used to develop the question being asked. The type of framework doesn't matter as much as the question being selected.

Think of these frameworks as you would for a house or building. A framework is there to provide support and to be a scaffold for the rest of the structure. In the same way, a research question framework can also help structure your evidence synthesis question.  

Health Social Sciences Interdisciplinary
  • PICO(T)
  • PHICOC
  • SPICE
  • PIECE
  • WWH
  • PROPHET

Organizing Your Question

PICO

to search for quantitative review questions

P: Patient or Population

I: Intervention (or Exposure)

C: Comparison (or Control)

O: Outcome

Variations Include:

PICOS

S: Study Design

PICOT

T: Timeframe

PICOC

C: Context

SPICE

to search for qualitative evidence

S: Setting (where?)

P: Perspecitve (for whom?)

I: Intervention (what?)

C: Comparison (compared with what?)    

E: Evaluation (with what result?)

SPIDER

 to search for qualitative and mixed methods research studies

S: Sample

PI: Phenomenon of Interest    

D:Design

E: Evaluation    

R: Research type

WWH

W: Who

W: What

H: How

ECLIPSE

to search for health policy/management information

E: Expectation (improvement or information or innovation)

C: Client group (at whom the service is aimed)    

L: Location (where is the service located?)    

I: Impact (outcomes)

P: Professionals (who is involved in providing/improving the service)

Se: Service (for which service are you looking for information)

PICO Template Questions

Try words from your topic in these templates.  Your PICO should fit only one type of question in the list.

For an intervention/therapy:

In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)?

For etiology:

Are ____ (P) who have _______ (I) at ___ (Increased/decreased) risk for/of_______ (O) compared with ______ (P) with/without ______ (C) over _____ (T)?

Diagnosis or diagnostic test:

Are (is) _________ (I) more accurate in diagnosing ________ (P) compared with ______ (C) for _______ (O)?

Prevention:

For ________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ (C)?

Prognosis/Predictions

In__________ (P) how does ________ (I) compared to _______(C) influence _______ (O) over ______ (T)?

Meaning

How do ________ (P) diagnosed with _______ (I) perceive ______ (O) during _____ (T)?

 

Template taken from Southern Illinois University- Edwardsville

Example PICO Questions

Intervention/Therapy:

In school-age children (P), what is the effect of a school-based physical activity program (I) on a reduction in the incidence of childhood obesity (O) compared with no intervention (C) within a 1 year period (T)?

In high school children (P), what is the effect of a nurse-led presentation on bullying (I) on a reduction in reported incidences of bullying (O) compared with no intervention (C) within a 6 month time frame (T)?

Etiology:

Are males 50 years of age and older (P) who have a history of 1 year of smoking or less (I) at an increased risk of developing esophageal cancer (O) compared with males age 50 and older (P) who have no smoking history (C)?

Are women ages 25-40 (P) who take oral contraceptives (I) at greater risk for developing blood clots (O) compared with women ages 25-40 (P) who use IUDs for contraception (C) over a 5 year time frame (T)?

Diagnosis/Diagnostic Test:

Is a yearly mammogram (I) more effective in detecting breast cancer (O) compared with a mammogram every 3 years (C) in women under age 50 (P)?

Is a colonoscopy combined with fecal occult blood testing (I) more accurate in detecting colon cancer (O) compared with a colonoscopy alone (C) in adults over age 50 (P)?

Prevention:

For women under age 60 (P), does the daily use of 81mg low-dose Aspirin (I) reduce the future risk of stroke (O) compared with no usage of low-dose Aspirin (C)?

For adults over age 65 (P) does a daily 30 minute exercise regimen (I) reduce the future risk of heart attack (O) compared with no exercise regimen (C)?

Prognosis/Predictions:

Does daily home blood pressure monitoring (I) influence compliance with medication regimens for hypertension (O) in adults over age 60 who have hypertension (P) during the first year after being diagnosed with the condition (T)?

Does monitoring blood glucose 4 times a day (I) improve blood glucose control (O) in people with Type 1 diabetes (P) during the first six months after being diagnosed with the condition (T)?

Meaning:

How do teenagers (P) diagnosed with cancer (I) perceive chemotherapy and radiation treatments (O) during the first 6 months after diagnosis (T)?

How do first-time mothers (P) of premature babies in the NICU (I) perceive bonding with their infant (O) during the first month after birth (T)?

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