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What is the Formulation of the Research Question in Systematic Review
Dr. Nancy Agens, Head,
Technical Operations, Pubrica
[email protected]
In Brief
Formulating a research question is the
challenging task for a researcher while
initiating a systematic review. This article
explains the different frameworks
available for formulating a high-quality
research question which includes PICO,
SPIDER, SPICE, ECLIPSE. A wellformulated research question needs to
have extreme specificity and preciseness
that guides the implementation of the
systematic review while keeping in mind
the identification of variables and
population of interest.
I. INTRODUCTION
For a systematic review, formulating a
well-constructed research question is
mandatory. The first step in executing a
Systematic Review is to formulate the
research question. Without formulating a
well-focused research question, it can be
challenging and time-consuming to
identify suitable studies and search for
relevant evidence. Forming a good
research question is not a straightforward
process as it requires engaging with the
literature.
Well-formulated
research
questions will guide many aspects during
the review process, which includes
determining eligibility criteria, search
studies, data collection for included
studies, and presenting findings. There are
different techniques used for formulating a
research question.
Practitioners of Evidence-Based Practice
(EBP) often use a specialized framework,
called PICO, to form the question and
facilitate the literature search. A systematic
review question typically focused on
narrow parameters and usually fitted into
the PICO question format.
P – Patient | Population | Problem
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Most important characteristics of
patients. Examples: Gender, age, and
disease or condition
I – Intervention or exposure
Main intervention. Examples: Drug
treatment, diagnostic and screening test
C – Comparison or control
Main
alternative.
Examples:
Standard therapy, placebo, no treatment
and gold standard
O – Outcome measures
What you are trying to accomplish,
improve, measure, affect. Examples:
Reduced mortality or morbidity, and
improved memory
For quantitative systematic review
question formation, PICO can be used
along with the variant such as PICOS (SStudy design), PICOC (C-Context), and
PICOT (T-timeframe).
A well-formulated review question will
assist in determining the inclusion and
exclusion criteria, the process of data
collection, the design of the search strategy
and the presentation of findings. A quality
question will allow finding the studyrelated information quickly, that are
relevant to the research studies and
accurately measures stated objectives. The
question also provides you with a checklist
for the main concepts to be included in
your search strategy.
Systematic review questions may be broad
or narrow in focus, but it is essential to
formulate the research question with care
to avoid lacking relevant studies or
collecting a potentially biased result set.
Several frameworks or models are
available to help the researchers develop a
research question, and some of the
alternatives are outlined below.
1
Question Type
Therapy
(Treatment)
Patient,
Population,
Problem
Patient's disease
or
disease
condition
Prevention
Risk factors for
patient's
and
common health
conditions
Diagnosis
Specific disease
or
disease
condition
The prognosis Time
and
(Forecast)
severity
of
major
prognostic
factor of clinical
issues
Aetiology
Patient's
risk
(Causation)
factors, general
health
conditions
or
current health
disorders
Intervention or Comparison or Outcome
exposure
control
measures
A therapeutic
measure such as
surgical
inventions,
medications or
change
in
lifestyle
Preventive
measures
including
medications or
change
in
lifestyle
Surgical
procedures or a
diagnostic test
Watchful
waiting
Standard care or Pain, mortality
a placebo
rate, disability
Preventative
measures or NA
Disease
incidence, the
mortality rate
The
current
standard test for
that disease or
disease
condition
NA
Sensitivity and
specificity
measures of the
test utility
Rate of disease
progression,
survival
rate,
the
mortality
rate
The
NA
Rate of disease
intervention or
progression,
an exposure of
survival
rate,
interest which
the
mortality
includes
an
rate
indication
of
strength, dose
of risk factor
and the duration
of exposure
Obtained from: https://canberra.libguides.com/systematic/question
Rather than interventions, it looks
at the reasons for behaviour and decisions
For qualitative and mixed research studies,
SPIDER can be used as an alternative to
PICO
D – Design
S – Sample
The type of research through
A qualitative research study is not
interview or survey
easy to generalize as the sample is
E – Evaluation
preferred over a patient
Outcome measures
PI – Phenomenon of Interest
R – Research type
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2
Quantitative, qualitative and mixed
methods
For qualitative evidence, SPICE can be
used
S – Setting (Where?)
Based on the location or
environment relevant to the research
P – Perspective or Population (for
Whom?)
The type of people that are being
studied
I – Intervention (What?)
The intervention, practice or
treatment that are used for evaluation
C – Comparison (compared with what?)
An intervention with which the
author compares the above comparator
E – Evaluation (with what result?)
The hypothetical result that is
intended to evaluate
For health policy and management
information, ECLIPSE can be used
E – Expectation
Improvement,
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 or
improving the service?
Se – Service
For which service are you looking
for information
Once you have a defined research
question, it is essential to make sure your
research is original, and it is not already
addressed. It can be identified through a
thorough search in the systematic review
databases (such as Cochrane Database of
Systematic Reviews, PROSPERO, The
Campbell Library, and Systematic Review
Data Repository (SRDR)) and be sure to
check with published reviews as well as
registered protocols.
In summary, a well-designed research
question is a starting point in conducting a
Copyright © 2020 pubrica. All rights reserved
high-quality systematic review, as it will
determine the nature and scope of the
systematic review, and there are several
frameworks available for formulating a
research questing and search for a new
finding. Once the research question
formulation is done, it is very much
necessary to check with the database to
avoid repetition.
REFERENCE
1.
2.
3.
4.
5.
Wilson, MC, Richardson, WS, Nishikawa, J &
Hayward, RS 1995, 'The well-built clinical
question: A key to evidence-based decisions', ACP
Journal Club, vol. 123, no. 3, pp. A12-A12.
Cooke, A, Smith, D & Booth, 2012, 'Beyond pico
the spider tool for qualitative evidence
synthesis', Qualitative Health Research, vol. 22, no.
10, pp. 1435-1443.
Cleyle, S & Booth, 2006, 'Clear and present
questions: Formulating questions for evidencebased practice', Library hi-tech, vol. 24, no. 3, pp.
355-368.
Wildridge, V & Bell, L 2002, 'How clip became
eclipse: A mnemonic to assist in searching for
health policy/management information', Health
Information & Libraries Journal, vol. 19, no. 2, pp.
113-115.
Beyond PICO: The SPIDER tool for qualitative
evidence synthesis Qual Health Res October 2012
vol. 22 no. 10 1435-1443
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