How to Formulate a Researchable Question based on PICOS

In Brief

One of the most difficult challenges a researcher faces before starting a project is generating a researchable question. Unanswered questions in current clinical practice and interactions dictating alternate treatments will lead to the formulation of a clinical research question. It would help researchers by giving them step-by-step instructions about how to formulate a research question. It also explains how to frame a research question using PICO (population, intervention, control, and outcomes) parameters ⁽¹⁾. Finally, before starting a research question, we evaluate the characteristics of a research project.

Introduction

A researchable question can be challenged, investigated, and analysed to provide valuable knowledge about an issue. A successful research experiment is determined by how well an author formulates the research issue in light of everyday research and clinical practice issues. The research project’s fundamental issues provide crucial details for determining whether the subject is appropriate, researchable, and meaningful⁽²⁾. A well-formulated research question necessitates excessive detail and precision, which guides the project’s execution while identifying variables and the population of interest. We’ll go through a clinical situation and see how clinical problems emerge and how they will help us with the facts we need to address our question.

Formulating the research question

Case

A 2-year-old boy with a fever and severe pain in his right ear visits an emergency doctor. His mother is concerned that he has been on the antibiotic amoxicillin for the last two weeks, and he has a history of chronic ear infections. She is worried about the long-term effects of antibiotic use. She’s still worried about the consequences of chronic ear infections. Because of its side effects, such as constant diarrhoea, she needs to know whether an amoxicillin prescription is safe or whether another antibiotic can replace it.

This case raises several questions, which can be divided into two categories: history and foreground. “Background Queries” are generic questions about a health condition or illness. These problems usually include comparing two objects, such as two medications or treatments, or two diagnostic processes, etc. PICO (population, intervention, control, and outcomes) is a commonly used method for framing a “foreground” study issue [Table 1].

Population or problem– Addressing a specific population, its important characteristics and demographic information. You may classify the paediatric population with otitis media, the age group, sex, presenting complaint, and experience from the above example from the above case.

Intervention or treatment of interest– Treatments, procedures, laboratory tests, and risk or prognostic variables are also examples of interventions. The intervention in this situation could be your treatment strategy for the patient, including new medication, a screening test, a prognostic factor, or a procedure. E.g., based on your observations in a clinic, cefuroxime is a safer therapeutic choice for otitis media than amoxicillin. Still, you are unsure about its effectiveness in paediatric otitis media patients.

Comparator or control– when a new treatment is linked to one that still exists

Outcome– The intervention’s result is known as the outcome—for example, its ability to manage discomfort. As a result, in the example above, the effect may be pain relief, infection resolution, or a reduction in the risk of developing resistance. A successful primary outcome should be simple to quantify, specific, valid, reproducible, and appropriate to your research issue.

In a traditional clinical environment, a clinician must be aware of context and foreground questions based on their knowledge of a specific condition and treatment. More background questions are presented after history questions are asked. Medical considerations emerge from a clinical work’s central problems. For instance, determining the causes or risk factors (etiological questions), evaluating diagnostic measures based on sensitivity and specificity (diagnostic question), determining the best treatment choices (therapeutic question), and the treatment outcome (prognostic question) ⁽³⁾.

Importance of PICO question

The PICO question is a different way of thinking about clinical issues that emerge in health care. These questions, unlike informational questions, are very complex and can be difficult to formulate. They are made up of particular elements or principles that have a specific role in the evidence-based process.

The PICO Formula

The fact that this procedure is known as formulating is no coincidence. When you ask a PICO question, you’re building a formula that accomplishes many goals ⁽⁴⁾:

• Define the elements or ideas in the query to help focus it.
• Used to determine which publications in a search retrieval better answer the query • Defines the principles that would be used when running a complex literature search
• Assists in determining whether the studies found to answer the initial question’s components.
• At the end of the review, you’ll have all the details you need to decide if the PICO action can be applied.

A concentrated research question contributes to structured research project preparation. It is not a shortage of concepts that is causing the difficulties in framing a study issue. The task is to transform a novel research issue into a proper study plan, which is the next step in the research question refinement process ⁽⁵⁾.

Conclusion

A well-formulated research topic is a good place to proceed when doing a good study or practising evidence-based medicine. A clinician should use the process outlined in this paper to formulate a question and look for a response, and a researcher can use it to create a new research project. The traditional method is first to classify a research question, then do a detailed literature review using the PICO criteria. If the research question is well-defined, it will lead to a good study design and methodology. Finally, the findings are applied to a particular patient group. In short, a researchable topic points to truth rather than opinions and is related to the ultimate purpose of the research project ⁽⁶⁾.

References

1. Amir-Behghadami, Mehrdad. “SPIDER as a framework to formulate eligibility criteria in qualitative systematic reviews.” BMJ Supportive & Palliative Care (2021).
2. Kruger, Stefanie Johanna Maria, and WENDY PHOSWA. “Association of TB treatment with pregnancy complications: A Systematic Review and Meta-analysis Protocol.” (2021).
3. Amir-Behghadami, Mehrdad, and Ali Janati. “Population, Intervention, Comparison, Outcomes and Study (PICOS) design as a framework to formulate eligibility criteria in systematic reviews.” Emergency medicine journal: EMJ 37.6 (2020): 387-387.
4. Ridderikhof, Milan L., and Markus Hollmann. “In reply: PICO questions in systematic reviews.” Emergency medicine journal: EMJ 37.6 (2020): 386-386.
5. Alkuwari, Hanaa I., et al. “Intrinsic predictive factors for acute and recurrent lateral ankle sprain in active and athlete population: A systematic review.” Middle East Journal of Family Medicine 7.10 (2020): 228.
6. Pérez, Jeff M., Chiara Alessi, and Magdalena Grzech-Wojciechowska. “Diagnostic methods for the canine idiopathic dilated cardiomyopathy: A narrative evidence-based rapid review.” Research in veterinary science 128 (2020): 205-216.