STEP 4: brainstorm your questions
Now you have explored different aspects of your topic, you may construct more focused questions (you can create a few questions and pick one later).
A background search will show you how others formulate their questions, hence expand your research direction.
Learn more:Clear and present questions: formulating questions for evidence based practice (Booth 2006)
This article provides an overview of thinking in relation to the theory and practice of formulation of answerable research questions.
STEP 5: Pick a question and focus
Once you have a few questions to choose from, pick one and refine it even further.
A background search may help you identify additional keywords in this step.
Are you required to use "PICO"?
- PICO
- PICO worksheet
- Other frameworks
- Learn more
The PICO framework (or other variations) can be useful for developing an answerable clinical question.
The example question used in this guide is a PICO question:
How does speech therapy compare to cognitive behavioural therapy in improving speech fluency in adolescents?
| P | Population OR Patient OR Problem What are the characteristics of the patient or population? OR What is the condition or disease you are interested in? | teenager with a stutter |
| I/E | Intervention OR Exposure What do you want to do with the patient (e.g. treat, diagnose, observe etc.)? | speech therapy |
| C | Comparison OR Comparator What is the alternative to the treatment (e.g.placebo, different drug, surgery)? | cognitive behavioural therapy |
| O | Outcome What is the relevant outcome (e.g. morbidity, complications)? | speech fluency |
Note: PICO is one option, there are other frameworks you can use too!
Use the interactive PICO worksheet to get started with your question, or you can download the worksheet document.
Here are some different frameworks you may want to use:
| PICO(T) | Population (patient), Intervention, Comparison (control) and Outcome. Add aTimeframe if required. Used particularly for treatment type questions. |
| PECO(T) | A variation of PICO where E= Exposure and T=Timeframe if required. |
| PIPOH | Developed in the context of practice guideline adaptation. Includes P= Professionals/Patients, O= Outcome and H= Healthcare Setting. |
| SPICE | S= Setting (where), P= Perspective (for whom), I= Intervention (what), C= Comparison (compared with what), E= Evaluation (Booth 2006). |
| SPIDER | S= Sample, P= Phenomenon of interest, D= Design, E= Evaluation, R= Research type. Useful for qualitative or mixed method studies (Cooke, Smith and Booth 2012). |
| ECLIPSE | E= Expectations, C= Client group, L= Location, I= Impact, P= Profession, SE= Service (Wildridge & Bell 2002). |
| PESTLE | P= Political, E= Economic, S= Social, T= Technological, E= Environmental, L= Legal (CIPD 2010). |
There are a number of PICO variations which can be used for different types of questions, such as qualitative, and background and foreground questions. Visit the Evidence-Based Practice (EBP) Guide to learn more: