What is the formulation of the research question in systematic review? - Pubrica

1. What is the Formulation of the Research Question in Systematic Review Dr. Nancy Agens, Head, Technical Operations, Pubrica sales@pubrica.com In Brief Formulating a research question is the challenging task for a researcher while initiating a systematic review. This article explains the different frameworks available for formulating a high-quality research question which includes PICO, SPIDER, SPICE, ECLIPSE. A well- formulated research question needs to have extreme specificity and preciseness that guides the implementation of the systematic review while keeping in mind the identification of variables and population of interest. I. INTRODUCTION For a systematic review, formulating a well-constructed research question is mandatory. The first step in executing a Systematic Review is to formulate the research question. Without formulating a well-focused research question, it can be challenging and time-consuming to identify suitable studies and search for relevant evidence. Forming a good research question is not a straightforward process as it requires engaging with the literature. Well-formulated research questions will guide many aspects during the review process, which includes determining eligibility criteria, search studies, data collection for included studies, and presenting findings. There are different techniques used for formulating a research question. Practitioners of Evidence-Based Practice (EBP) often use a specialized framework, called PICO, to form the question and facilitate the literature search. A systematic review question typically focused on narrow parameters and usually fitted into the PICO question format. P–Patient | Population | Problem Most important characteristics of patients. Examples: Gender, age, and disease or condition I–Intervention or exposure Main intervention. Examples: Drug treatment, diagnostic and screening test C–Comparison or control Main alternative. Standard therapy, placebo, no treatment and gold standard O–Outcome measures What you are trying to accomplish, improve, measure, affect. Examples: Reduced mortality or morbidity, and improved memory For quantitative question formation, PICO can be used along with the variant such as PICOS (S- Study design), PICOC (C-Context), and PICOT (T-timeframe). A well-formulated review question will assist in determining the inclusion and exclusion criteria, the process of data collection, the design of the search strategy and the presentation of findings. A quality question will allow finding the study- related information quickly, that are relevant to the research studies and accurately measures stated objectives. The question also provides you with a checklist for the main concepts to be included in your search strategy. Systematic review questions may be broad or narrow in focus, but it is essential to formulate the research question with care to avoid lacking relevant studies or collecting a potentially biased result set. Several frameworks available to help the researchers develop a research question, and some of the alternatives are outlined below. Examples: systematic review or models are Copyright © 2020 pubrica. All rights reserved 1

2. Question Type Patient, Population, Problem Patient's disease or condition Intervention or exposure Comparison or control Outcome measures Therapy (Treatment) A measure such as surgical inventions, medications or change lifestyle Preventive measures including medications or change lifestyle Surgical procedures or a diagnostic test therapeutic Standard care or a placebo Pain, mortality rate, disability disease in Prevention Risk factors for patient's common health conditions Preventative measures or NA Disease incidence, mortality rate and the in Diagnosis Specific disease or condition The standard test for that disease or disease condition NA current Sensitivity and specificity measures of the test utility disease The (Forecast) prognosis Time severity major prognostic factor of clinical issues Patient's factors, general health conditions current disorders and of Watchful waiting Rate of disease progression, survival the mortality rate rate, Aetiology (Causation) risk The intervention or an exposure of interest includes indication strength, of risk factor and the duration of exposure NA Rate of disease progression, survival the mortality rate rate, or which health an of dose Obtained from: https://canberra.libguides.com/systematic/question For qualitative and mixed research studies, SPIDER can be used as an alternative to PICO S–Sample A qualitative research study is not easy to generalize as the sample is preferred over a patient PI–Phenomenon of Interest at the reasons for behaviour and decisions D–Design The type of research through interview or survey E–Evaluation Outcome measures R–Research type Rather than interventions, it looks Copyright © 2020 pubrica. All rights reserved 2

3. methods For qualitative evidence, SPICE can be used S–Setting (Where?) Based on environment relevant to the research P–Perspective or Population (for Whom?) The type of people that are being studied I–Intervention (What?) The intervention, treatment that are used for evaluation C–Comparison (compared with what?) An intervention with which the author compares the above comparator E–Evaluation (with what result?) The hypothetical result that is intended to evaluate For health policy and management information, ECLIPSE can be used E–Expectation Improvement, Innovation C–Client group At whom the service is aimed L–Location where is the service located? I–Impact Outcomes P–Professionals who is involved in providing or improving the service? Se–Service For which service are you looking for information Once you have a defined research question, it is essential to make sure your research is original, and it is not already addressed. It can be identified through a thorough search in the systematic review databases (such as Cochrane Database of Systematic Reviews, PROSPERO, The Campbell Library, and Systematic Review Data Repository (SRDR)) and be sure to check with published reviews as well as registered protocols. In summary, a well-designed research question is a starting point in conducting a Quantitative, qualitative and mixed high-quality systematic review, as it will determine the nature and scope of the systematic review, and there are several frameworks available for formulating a research questing and search for a new finding. Once the research question formulation is done, it is very much necessary to check with the database to avoid repetition. REFERENCE 1. Wilson, MC, Richardson, WS, Nishikawa, J & Hayward, RS 1995, 'The well-built clinical question: A key to evidence-based decisions', ACP Journal Club, vol. 123, no. 3, pp. A12-A12. 2. Cooke, A, Smith, D & Booth, 2012, 'Beyond pico the spider tool for synthesis', Qualitative Health Research, vol. 22, no. 10, pp. 1435-1443. 3. Cleyle, S & Booth, 2006, 'Clear and present questions: Formulating questions for evidence- based practice', Library hi-tech, vol. 24, no. 3, pp. 355-368. 4. Wildridge, V & Bell, L 2002, 'How clip became eclipse: A mnemonic to assist in searching for health policy/management Information & Libraries Journal, vol. 19, no. 2, pp. 113-115. 5. Beyond PICO: The SPIDER tool for qualitative evidence synthesis Qual Health Res October 2012 vol. 22 no. 10 1435-1443 the location or practice or qualitative evidence information', Health Information or Copyright © 2020 pubrica. All rights reserved 3