Evidence Based Practice: Formulating an Evidence-Based Clinical Question

Phrasing your question:

Poorly thought out questions (often posed as statements or title statements) often lead to unfocused research and affect outcome quality. It is crucial to effectively communicate the relevance, pertinence and focus of your research question to your audience. The wording of your question sets expectations and captures the essence of your research. 

As the Question is the main point of your research, it is important to take time and find out:

• Do you know the field and its literature well? 
• What are the important research questions in your field? 
• What areas need further exploration? 
• Is the timing right for this question – hot topic or obsolete? 
• Will the question have a significant impact on this field?

Once these points have been addressed, then: 

1 Specify your specific concern or issue 

2 Decide what you want to know about the specific concern or issue 

3 Turn what you want to know and the specific concern into a question 

4 Ensure that the question is answerable

5 Check to make sure the question is not too broad or too narrow

There are many excellent online resources that explain the principles of evidence-based literature searching  and some of these use the PICO framework:

PICO(T) Framework
The first stage of any evidence-based practice process is formulating an answerable question. This forms the foundation for quality searching. A well-formulated question will facilitate the search for evidence and will assist you in determining whether the evidence is relevant to your question.
An answerable question has a format that follows the PICO(T) framework. The acronym translates to:

P – Population/Patient/Participant/Problem

I –  Intervention, Issue, Treatment or Exposure*

C – Comparison/Control

O – Outcome

Optional model component:

T -- Timeframe for data collection or time taken to demonstrate a clinical outcome

*To avoid the search becoming too broad, it is advisable to apply one intervention only at a time. Applying other interventions may need to be separate searches.   

The PICO Framework helps to identify suitable keywords for your search strategy.

The Who, What, Where, How then may help to inform the type of research you undertake: E.g. Qualitative; Quantitative; Mixed Methods.

SVHA Resource

Identifying an evidence practice gap and designing your research question 
©Dr Lauren Christie, Senior Implementation Science Research Fellow-Allied Health, St Vincent's Health Network, Sydney.

Other "Question Formulation" Models to consider:

The ProPHeT and SPIDER Frameworks

 ProPHeT Framework - PROblem, PHEnomenon, Time

Clinical question format for complex qualitivative research adaptations. 

Framing your research question -ProPHeT (© CQ University)

SPIDER Framework -   Sample, Phenomenon of interest, Design, Evaluation, Research type

The Spider format enables research questions to include and evaluate experiences a specific phenomenon.

Evidence-Based Practice: PICO and SPIDER (© Charles Stuart University)

Ask an Evidence based Clinical Question (© University of South Australia includes clinical question example modules)

Resorces

Cooke, A., Smith, D., & Booth, A. (2012). Beyond PICO: The SPIDER tool for qualitative evidence synthesis. Qualitative Health Research, 22(10), 1435–1443. https://doi.org/10.1177/1049732312452938