Systematic Reviews: Develop & Refine Your Research Question

This guide provides information and resources which may be helpful when undertaking a systematic review or other type of knowledge synthesis.

Develop & Refine Your Research Question

A clear, well-defined, and answerable research question is essential for any systematic review, meta-analysis, or other form of evidence synthesis. The question must be answerable. Spend time refining your research question.

PICO Framework

Focused Question Frameworks

The PICO mnemonic is frequently used for framing quantitative clinical research questions.1

P Patient or problem being addressed
I Intervention or exposure being studied
C Comparison intervention or exposure
O Clinical Outcome


The PEO acronym is appropriate for studies of diagnostic accuracy2

P Patient
E Exposure (the test that is being evaluated)
O Outcome


The SPICE framework is effective “for formulating questions about qualitative or improvement research.”3

S Setting of your project
P Population being studied
I Intervention (drug, therapy, improvement program)
C Comparison
E Evaluation (how were outcomes evaluated?)


The SPIDER search strategy was designed for framing questions best answered by qualitative and mixed-methods research.4

S Sample: what groups are of interest?
PI Phenomenon of Interest: what behaviors, decisions, or experience do you want to study?
D Design: are you applying a theoretical framework or specific research method?
E Evaluation: how were outcomes evaluated and measured?
R Research type: qualitative or mixed-methods?


References & Recommended Reading

1.          Anastasiadis E, Rajan P, Winchester CL. Framing a research question: The first and most vital step in planning research. Journal of Clinical Urology. 2015;8(6):409-411.

2.          Speckman RA, Friedly JL. Asking Structured, Answerable Clinical Questions Using the Population, Intervention/Comparator, Outcome (PICO) Framework. PM&R. 2019;11(5):548-553.

3.          Knowledge Into Action Toolkit. NHS Scotland. Accessed April 23, 2021.

4.          Cooke A, Smith D, Booth A. Beyond PICO: the SPIDER tool for qualitative evidence synthesis. Qualitative health research. 2012;22(10):1435-1443.