Skip to Main Content
It looks like you're using Internet Explorer 11 or older. This website works best with modern browsers such as the latest versions of Chrome, Firefox, Safari, and Edge. If you continue with this browser, you may see unexpected results.

Database Searching - Health: Using a Question Framework

Guide for Database Searching for the Health Sciences

Using a framework to structure your question

Frameworks help researchers structure a research question and clarify search concepts.  There are many different frameworks depending on the type of question.  For clinical questions, the most well-known is PICO.  Sometimes your question may not fit perfectly into a framework.  You can use part of a framework if necessary.

Which Framework?

  • Effectiveness of a treatment or intervention: PICO
  • Prognostic: PFO
  • Prevalence/Incidence: CoCoPop
  • Cost/benefit analysis: PICOC, CLIP, ECLIPS(E)
  • For qualitative questions: PICo, PEO, SPICE, SPIDER

PICO

(for questions covering the effectiveness of an intervention, treatment etc.)

Patient, Population or Problem - who is the patient and/or what is the problem?
Intervention - what intervention is being considered?
Comparison - what intervention is this being compared with (a comparison is not always necessary)
Outcomes - what do you hope to accomplish, improve or affect?

 

Example:  Alternatives to drugs for controlling headaches in children

  • P - children
  • I - alternatives to drugs (complementary therapies? changes to lifestyle?)
  • C - drugs
  • O - controlling headaches

 

Extensions to PICO

There are extensions to the PICO framework available which you can use if your topic has additional concepts:

  • PICOS- here the S stands for study designs or setting (you can use this framework if you are only interested in examining specific designs of study or if the intervention is setting-specific like a hospital or nursing home)
  • PICOT- here the T stands for timeframe (you can use this framework if your outcomes need to be measured in a certain amount of time e.g. 24 hours after surgery).

Alternatives to PICO

  • SAPO (Setting, Approach, Primary Outcomes)

PFO

(for questions relating to prognosis issues)

Population- who and/or what is my question focused on?

Prognostic Factors- what is being prognosed?

Outcomes- what are the possible outcomes of the prognosis?

 

Example: How likely are children with febrile seizures to develop a seizure disorder?

  • P- children
  • F- febrile seizures
  • O- seizure disorders

 

CoCoPop

(for questions relating to the prevalence/incidence of a condition, problem etc.)

Condition- what condition/problem are you examining?

Context- in what context is your question set?

Population- what population/group are you examining

 

Example: What is the prevalence of claustrophobia in adult patients undergoing MRI?

  • Condition- claustrophobia
  • Context- MRI
  • Population- adults

PICOC

(for questions relating to cost/benefit, economic evaluations, service improvements etc.)

Patient, Population or Problem - who is the patient and/or what is the problem?

Intervention - what intervention is being considered?

Comparison - what intervention is this being compared with? (a comparison is not always necessary)

Outcomes - what do you hope to accomplish, improve or affect?

Context- in what context or place is the problem set?

 

Example: What is the cost effectiveness of self monitoring of blood glucose in type 2 diabetes in high income countries?

  • P- type 2 diabetes
  • I- self monitoring of blood glucose
  • C- N/A
  • O- cost effectiveness
  • C- high income countries

 

Alternatives to PICOC

  • PEAHEN (Population, Exposure, Adverse Health Effects, Negative reactions)

CLIP

(for questions relating to cost/benefit, economic evaluations, service improvements etc.)

Client – who is the service aimed at?

Location – where is the service site?

Improvement – what do you want to find out?

Professional – who is involved in providing/improving the service?

 

Example: Ways of improving health visiting services to elderly in rural communities

  • C - elderly
  • L - rural communities
  • I - how services can be improved
  • P - health visiting

ECLIPS(E)

(for questions relating to cost/benefit, economic evaluations, service improvements etc.)

Expectation - why do you need the information?
Client Group -who is the information needed for - e.g. health managers, GPs, patients
Location - where is the client group or service located
Impact - what is the change in the service, if any, you are looking for? What would constitute success? How is this being measured?
Professionals - what health professionals are involved in the service?
Service - what service are you considering changing? For example, outpatient services, nurse-led clinics, intermediate care.

 

Example:  retention of ICU nurses in the US

  • E- to find out retention rates
  • C- (patients? managers?)
  • L- US
  • I- retention of staff
  • P- nurses
  • S- ICU

PICo

(for qualitative questions evaluating experiences, meaningfulness etc.)

Patient, Population or Problem- who is the patient and/or what is the problem?

Interest- a defined event, experience, activity or process

Context- a setting or distinct characteristics

 

Example: What are the experiences of patients with pressure sores who receive treatment at home?

  • P- patients with pressure sores
  • I- experiences, views, opinions
  • Co- care in the home

PEO

(for qualitative questions evaluating experiences, meaningfulness etc.)

Population - who is my question focused on?

Exposure - what is the issue I'm interested in?

Outcomes or themes - what theme do I want to examine?

 

Example: The quality of life of caregivers for people with dementia

  • P- caregivers
  • E- dementia
  • O- quality of life

 

Alternatives to PEO

  • PEAS (Problem, Experiment, Alternative, Setting)
  • PIE (Problem, Intervention, Evaluation)

SPICE

(for qualitative questions evaluating experiences, meaningfulness etc.)

Setting - where is the study set e.g. in a specific country, community, in a hospital, in a care home etc.
Perspective - from whose perspective is the study done - e.g. the patients, the health professionals., the caregivers etc.
Intervention - what intervention is being examined?
Comparison - is the intervention being compared with another?
Evaluation - the outcome measures

 

Example: Attitudes of caregivers of people with dementia towards reminiscence therapy

  • S - (United Kingdom? care homes?)
  • P - caregivers
  • I - reminiscence therapy
  • C - NONE
  • E - attitudes

 

Alternatives to SPICE

  • SugABABes (Suggested Approach, Best Alternative, Best compromise)

SPIDER

(for qualitative questions evaluating experiences, meaningfulness etc.)

Sample - the group of people being looked at - because qualitative research is not easy to generalize, sample is preferred over patient.
Phenomenon of Interest -  reasons for behavior and decisions, rather than an intervention.
Design - the form of research used, such as interview or survey.
Evaluation - outcome measures.
Research type - qualitative, quantitative and/or mixed methods.

 

Example:  Young parents experiences of attending prenatal education

  • S - young parents
  • PI - attendance at prenatal education classes
  • D - (interviews? surveys?)
  • E - experiences
  • R - (qualitative studies?)