Search frameworks/mnemonics

Search framework

Time needs to be spent structuring and refining your research question. A search framework can help break your scenario or research question into parts or concepts. Examples of search frameworks commonly used in Health include PICO and SPiDER.

Why use them?

Provides an opportunity to brainstorm
To help identify key concepts
Can be the foundation for developing a search strategy
To find relevant results/evidence

Whilst structuring your clinical question using a mnemonic or framework is an important aspect of systematic searching, it may not be necessary to include all of the concepts in your search. Only use those concepts that can be clearly defined and translated into search terms.

PICO

The PICO framework can provide a useful structure to guide the development of your question. Think about your information need and identify:

P - the population, patient or problem being addressed
I - what main intervention or issue are you considering?
C - what will the intervention/issue be compared to? (not all questions will include a comparison)
O - what outcome does the intervention/issue seek to accomplish, measure, improve or affect?

Questions may be constructed as:

In P, how does I compared to C affect O?

E.g. In patients with type 2 diabetes (P), how does the implementation of regular physical exercise (I) compared to standard care without exercise (C) affect glycemic control (O)?

You might also add:

Research design - which study type is most appropriate to answer this question? e.g. Randomised controlled trial, cohort study, systematic review, etc.

Let's use the search mnemonic PICO to develop a research question from the following clinical scenario:

Ruby, a 16-year-old female, is brought to your clinic by her parents. Recently having been diagnosed with Attention deficit hyperactivity disorder (ADHD), Ruby's school has suggested that Cognitive Behavior Therapy (CBT) may help Ruby understand and manage her symptoms. After doing some Googling Ruby's parents believe Family-based therapy (FBT) may be a successful all family approach. Your first thought for treatment is a combination of both FBT and CBT. You wish to check the latest evidence before you prescribe.

**PICO**
POPULATION/PROBLEM CONCEPT 1	INTERVENTION CONCEPT 2	COMPARISON CONCEPT 3	OUTCOME CONCEPT 4
Attention deficit hyperactivity disorder (ADHD)	Cognitive Behavior Therapy (CBT)	Family Based Treatment (FBT)

What is the efficacy of cognitive-behavioural therapy or family-based therapy or their combination in the treatment of ADHD in children?

For a thorough explanation of PICO and its use in systematic reviews, see Articulating the review and comparison PICO #section-3-2

SPICE & SPIDER - Quantitative question

SPICE and SPIDER are search frameworks that can be used when undertaking qualitative research to help formulate your research question and guide your search strategy. SPICE and SPIDER are a qualitative alternative to PICO (quantitative). They allow the researcher to focus on attitudes, views, experiences and feelings for example. Below is a breakdown of what SPICE and SPIDER stand for:

SPICE

S -Setting	P - Perspective	I - Intervention, exposure or interest	C - Comparison	E - Evaluation
Setting is the context for the question - where	Perspective is the users, potential users or stakeholders of the service - for whom	Intervention is the action for the users, potential users or stakeholders - what	Comparison is the alternative actions or outcomes - what else	Evaluation is the result or measurement that will determine the success of the intervention - what result or how well

What the experiences and coping strategies of parents caring for a child with autism?

SPIDER

S -SAMPLE	PI - PHENOMENON OF INTEREST	D - DESIGN	E - EVALUATION	R - RESEARCH TYPE
Parents or primary caregivers to children with autism	Experiences and coping strategies	Qualitative studies, interviews or focus groups	Feelings or perceptions	Qualitative research