The first stage of evidence-based practice is to convert information needs from practice into focused, structured questions. Effective question formation is essential for efficient literature searching.
Evidence-Based Practice for Information Professionals
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PICO
A mnemonic to format a clinical research question into searchable keywords. Used for clinical, quantitative-type questions. Elements do not have to be in the PICO order.
| Patient OR Population OR Problem | What are the characteristics of the patient or population? |
| Intervention OR Exposure | What do you want to do with this patient (e.g. treat, diagnose, observe)? |
| Comparison | What is the alternative to the intervention (e.g. placebo, different drug, surgery)? |
| Outcome | What are the relevant outcomes (e.g. morbidity, complications)? |
| (T) | Time |
| (S) | Study design |
Example: Among pregnant mothers (Population), is a touchscreen information service (Intervention) more effective than printed information leaflets (Comparison) in terms of knowledge of factors likely to cause prenatal harm (Outcome)?
Sources:
Booth, Andrew. “Formulating Answerable Questions.” In Evidence-Based Practice for Information Professionals: A Handbook, 304. London: Facet Publishing, 2004.
PerSPECTiF
Factors in the sociocultural acceptability of an intervention, as well as contextual factors that impact on the feasibility of that intervention. Used for qualitative research.
| Perspective | |
| Setting | |
| Phenomenon of interest/Problem | |
| Environment | |
| Comparison (optional) | |
| Time/Timing | |
| Findings |
Source: Booth, Andrew, Jane Noyes, Kate Flemming, Graham Moore, Özge Tunçalp, and Elham Shakibazadeh. “Formulating Questions to Explore Complex Interventions within Qualitative Evidence Synthesis.” BMJ Global Health 4, no. Suppl 1 (2019): e001107. https://doi.org/10.1136/bmjgh-2018-001107.
SPIDER
An alternative search strategy tool for qualitative/mixed methods research
| Sample | The group of people being looked at |
| Phenomenon of Interest | Looks at the reasons for behaviour and decisions, rather than an intervention. |
| Design | The form of research used, such as interview or survey. |
| Evaluation | The outcome measures. |
| Research Type | Type of research. e.g. qualitative, quantitative or mixed method |
Example: What are the experiences (evaluation) of women (sample) undergoing IVF treatment (phenomenon of interest) as assessed?
Source: Cooke A, Smith D, Booth A. Beyond PICO: the SPIDER tool for qualitative evidence synthesis. Qual Health Res. 2012 Oct;22(10):1435-43. doi: 10.1177/1049732312452938. Epub 2012 Jul 24. PMID: 22829486.
SPICE spits the population component into both setting and perspective and adds an evaluation component.
| Setting | Where? |
| Perspective | For whom? |
| Intervention | What? |
| Comparison | Compared with what? |
| Evaluation | With what results? |
Example: "How effective are text message reminders (intervention) compared to phone call reminders (comparison) in improving class attendance (evaluation) among college students (perspective)?"
Source: Booth, Andrew. “Clear and Present Questions: Formulating Questions for Evidence Based Practice.” Library Hi Tech 24, no. 3 (2006): 355–68. https://doi.org/10.1108/07378830610692127.
Many frameworks have been developed and can be found in these resources
University of Maryland Libraries. Systematic Review-Framing a Research Question. Includes a table of over 40 question frameworks.
James Cook Library Guides: Scoping Reviews>Plan>Define the Question
Key articles in addition to those referenced:
Booth, Andrew. “Clear and Present Questions: Formulating Questions for Evidence Based Practice.” Library Hi Tech 24, no. 3 (2006): 355–68. https://doi.org/10.1108/07378830610692127.
Booth, Andrew. “Formulating Answerable Questions.” In Evidence-Based Practice for Information Professionals: A Handbook, 304. London: Facet Publishing, 2004.
Booth, Andrew, Jane Noyes, Kate Flemming, Graham Moore, Özge Tunçalp, and Elham Shakibazadeh. “Formulating Questions to Explore Complex Interventions within Qualitative Evidence Synthesis.” BMJ Global Health 4, no. Suppl 1 (2019): e001107. https://doi.org/10.1136/bmjgh-2018-001107.
Cooke, Alison, Debbie Smith, and Andrew Booth. “Beyond PICO: The SPIDER Tool for Qualitative Evidence Synthesis.” Qualitative Health Research 22, no. 10 (October 2012): 1435–43. https://doi.org/10.1177/1049732312452938.
Davies, Karen Sue. “Formulating the Evidence Based Practice Question: A Review of the Frameworks.” Evidence Based Library and Information Practice 6, no. 2 (June 24, 2011): 75–80. https://doi.org/10.18438/B8WS5N.
PRISMA
Provides guidelines to address several conceptual and practical advances in the science of systematic reviews of studies that evaluate the effects of health interventions, irrespective of design. It is an evidence-based minimum set of reporting items.
AMSTAR
AMSTAR is an instrument used in assessing the methodological quality of systematic reviews