Formulating a focused research question is an essential part of making a search protocol. A focused research question is useful in the process of structuring, clarifying and defining the search strategy, and can be based on e.g. the PICO structure describing 4 domains of a clinical research question: Population, Intervention, Comarator and Outcome (Faber Frandsen et al., 2014). PICO can be expanded to PICOT if Timing is of relevance (e.g. postpartum) or PICOS if Setting is of importance. PICO worksheet (or as docx)

PICO is suited for clinical research questions concerning the effectiveness of interventions but other models of conceptualization can be used for qualitative research questions:

  • PEO represents Patient, Exposure, Outcome suited for qualitative research questions (Khan et al, 2003).
  • Furthermore Saini and Schlonsky recommend a focus on Population, Context and Location (Saini & Shlonsky 2012, s. 96).
  • SPICE is a more complex model represented by Setting, Population, Intervention, Comaprison and Evaluation (Booth, 2006).
  • SPIDER is another model adapted to qualitative research questions: Sample, Phenomenon of Interest, Design, Evaluation and Research type (Cooke et al., 2012).
  • PICo is useful when the question concerns a patient group and a phenomenon of Interest in a specific context (Joanna Briggs Institute, 2011).

PICo worksheet (or as docx)

Tove Faber Frandsen, Anne-Kirstine Dyrvig, Janne Buck Christensen et al. En guide til valide og reproducerbare systematiske litteratursøgninger. Ugeskrift for Læger (2014), 176(7): 647- 651.

Saini M, Shlonsky A. Systematic synthesis of qualitative research. New York: Oxford University Press; 2012. xiv, 208 p. p.

Cooke A, Smith D, Booth A. Beyond PICO: the SPIDER tool for qualitative evidence synthesis. Qual Health Res. 2012 Oct;22(10):1435-43.

Booth A. Clear and present questions: formulating questions for evidence based practice. Libr Hi Tech. 2006;24(3):355-68.

Khan KS, Kunz R, Kleijnen J, Antes G. Systematic Reviews to Support Evidence-Based Medicine. How to Review and Apply findings of Health Care Research. London: RSM Press, 2003.

Joanna Briggs Institute 2011. Joanna Briggs Institute Reviewers' Manual 2011. The University of Adelaide, South Australia, 2011.

Quality Appraisal

The quality assessment of the evidence of included studies can be guided by various quality appraisal tools adjusted to the design qualities of different study types:

GRADE (The Grades of Recommendation, Assessment, Development and Evaluation) is a transparent approach to grading quality of evidence and strength of recommendations in systematic reviews and clinical guidelines. The evidence is rated within five categories (within-study risk of bias (methodological quality), directness of evidence, heterogeneity, precision of effect estimates and risk of publication bias) leading to an overall quality assessment ranging from high-moderate-low-very low. Several organizations worldwide have endorsed or are using GRADE including Cochrane Collaboration, BMJ Clinical Evidence, National Institute for Health and Care Excellence (NICE), UpToDate® etc. Learn more at The GRADE Working Group.

Search History

Search histories from PubMed are quite easy to save (they are already formatted as simple tables).

Ovid (incl. Embase) or EBSCOHOST (incl. Cinahl)

It may be slighly more difficult to save search histories from these platforms as simple tables. To make the process a bit easier, the following bookmarklet is provided: search history helper.

  1. Drag the link to the script to the bookmarks toolbar
  2. Perform the search / refresh the search results (everything you wish to copy must be visible on the page)
  3. Click on the bookmark you created in step 1
    1. A small box should appear on the page showing a table with the search history
    2. Click this table (once) to select all of it
    3. Copy (Ctrl-C, Ctrl-V) the table into some other application (for example Word)

Note: The script works best with Chrome. Make sure that the result counts appear on the page - when revisiting saved searches, press Select all and Refresh Search Results to get these numbers (on EBSCOHOST).

The code behind the bookmarklet along with a slighly more technical description can be found here (the script is inspired by OvidSH).

Final Reporting

The EQUATOR Network (Enhancing the QUAlity and Transparency Of health Research) has compiled reporting guidelines for main study types.