LibGuides: Responsible Literature Searches: Search Preparation

Tips for Creating a Research Question

Crafting your research question is a foundational part of the literature search as it will

guide the process of finding good keywords and
aid in the selection of the appropriate databases to begin searching (both points will be talked about in following pages).

Searching is an iterative process, which means the question will likely change somewhat as you begin researching. A good way to start formulating the question is by considering your background questions and foreground questions then applying a research framework like PICO to begin research.

Background Questions

Before forming a clinical question, you may need to answer background questions. Background questions ask for general knowledge about an illness, disease, condition, process or thing.

An example of a background question is “What is bibliotherapy?”

This is a general question that can be answered by sources such as:

Reference books
Textbooks
Drug monographs
Other sources which provide an overview of a topic

(Don’t waste time consulting published articles for questions that could be answered definitively by secondary source material as outlined above).

Foreground Questions

Foreground questions ask for specific knowledge about a Patient or problem, an Intervention, Comparison, and Outcome (commonly referred to as PICO).

An example of a foreground question is “Is bibliotherapy helpful in reducing the anxiety of child cancer patients?”

This is a research/evidence focused question which can be answered by sources such as:

Systematic reviews
Practice guidelines
Meta-analyses
Other primary source materials

PICO (And Other Research Question Frameworks)

PICO
Other Frameworks

PICO

To ensure that your question is concise and searchable try using a framework like PICO to pull out the main ideas of your initial question. PICO stands for Population (or Problem), Intervention (or Exposure), Comparison (or Control), and Outcome. Below is a chart that helps determine what each part of the framework is really asking so you can better apply it to your own question.

P	Population (or Problem)	"How would I describe a group of patients similar to mine?"
I	Intervention (or Exposure)	"Which main intervention, prognostic factor, or exposure am I considering?"
C	Comparison (or Control)	"What is the main alternative to compare with the intervention?"
O	Outcome	"What can I hope to accomplish, measure, improve, or affect for my patient or population?"

Examples

Take a look at the two examples below to get some practice on applying the PICO framework to different clinical questions.

Example Question 1	Where can we apply PICO?	Tips
Does TENS (transcutaneous electrical nerve stimulation) (I) reduce pain (O) from primary dysmenorrhea (P)?	Does ________(I) reduce ________ (O) from _________ (P)?	In this example there was no comparison implied. We could assume that the comparison is placebo or any other kind of pain relief method.

Example Question 2	Where can we apply PICO?	Tips
In young children with middle ear effusion (P), is microtympanometry (I) more accurate compared to medical history and otoscopy (C) in diagnosing hearing loss (O)?	In _______ with _______(P), are (is) _______(I) more accurate in diagnosing _______(O) compared with _______(C)?	Sometimes switching around the question can help to visualize the terms more clearly.

For more in depth instruction on the PICO framework visit the National Library of Medicine's guide on Using PICO to Frame a Clinical Question. This guide also includes some interactive exercises for breaking down a question into PICO.

COCOPOP

Condition, Context, Population

PEO

Population, Exposure of Interest, Outcome or Response

PICOS

Population or Problem, Intervention or Exposure, Comparison or Control, Outcome, Study Type

PICOT

Population or Problem, Intervention or Exposure, Comparison or Control, Outcome, Time

PIRD

Population, Index Test, Reference Test, Diagnosis of Interest

SPIDER

Sample, Phenomenon of Interest, Design, Evaluation, Research Type

SPICE

Setting, Perspective, Intervention, Comparison, Evaluation

Documentation

The best way you can manage the iterative nature of literature searching is by documenting everything. Documentation can occur in a Word document or Excel spreadsheet.

What to Document:

your research question (may occur earlier on in the process)
the databases searched;
the search strategy
any filters applied, such as language or date;
the number of results;
and any evidence identified through other methods, such as handsearching or cross referencing.

Why Document?

Evidence-Based Medicine

Documenting your searches ensures that your finished product is reproducible and transparent to those reviewing or reading your work. This is the standard within evidence-based medicine to ensure that anyone replicating your search will arrive at the exact same results. Additionally, if you are researching to eventually publish, this type of documentation is required within the methodology section of a review by many publishers.

Saving Time

Documenting throughout the process also saves you time. If you leave off and close out of the databases, there is a good chance that the database did not save any previous searches. Keeping an up to date document with all your search terms, result numbers, filters, etc. will prevent you from having to start over.