Frameworks
Purpose of frameworks in developing research questions for reviews
In research there is a potential of coming across the term "framework" in multiple contexts. For the purpose of developing a review the term "framework" refers to a tool used to formulate the research question. Frameworks provide a structured approach to the review process, by defining boundaries on the research question to make sure it stays focused on a specific topic.
Frameworks can be helpful in formulating a clear and answerable research question, by identifying the elements within the question.
There are many frameworks which can be customised to address different types of research questions. The most well-known framework is PICO, used to frame questions about the effectiveness of interventions. However, many other frameworks are suitable to address this type of question, as well as all types of questions across multiple discipline areas.
Note
Read the articles listed below for more information about using frameworks to form a research question for your review:
- Formulating the Evidence Based Practice Question: A Review of the Frameworks by K. S. Davies.
- Formulating questions to explore complex interventions within qualitative evidence synthesis by A. Booth et al. See supplementary material, for information specific to using frameworks to develop a question for a rapid review.
Explore common frameworks
There are various types of frameworks that can be applied to a research question. Frameworks can help to identify the key elements within a research question. This module focuses on commonly used frameworks in Health and Sciences literature based research.
Click on the plus (+) icons below to explore the definition, purpose, and examples for each framework type.
PICO
Definition and purpose
The PICO framework is useful for questions about the effectiveness of interventions.
PICO stands for:
- Population or Patient or Problem
- Intervention or Indicator
- Comparison or Control
- Outcome
Scenario
Wrist splints are commonly prescribed for people with carpal tunnel syndrome. You want to know what evidence there is for their effectiveness in reducing pain and increasing wrist function.
Research question
What is the effectiveness of wrist splints (I) compared with corticosteroid injections (C) for reducing pain and increasing function (O) in for carpal tunnel syndrome (P)?
Framework and scenario matching
| Element | Definiton | Scenario |
|---|---|---|
| P (patient/population/problem) | Who is the population of interest? OR What is the problem of interest? |
People with carpal tunnel syndrome |
| I (intervention/indicator) | What is the intervention or indicator of interest? | Wrist splits |
| C (comparison/control) | What are you comparing the intervention to? | Corticosteroid injections |
| O (outcome) | What is the outcome of interest? | Improvement of pain and wrist function |
Example research paper
Karjalainen, T. V., Lusa, V., Page, M. J., O'Connor, D., Massy-Westropp, N., & Peters, S. E. (2023). Splinting for carpal tunnel syndrome. Cochrane Database of Systematic Reviews, (2).
Variant PICO Frameworks
PICO has variations and extensions to accommodate different question types, including qualitative questions. For example:
- PICOS stands for PICO plus Study design
- PICOT stands for PICO plus Time
- PECO stands for Population/Problem, Exposure, Comparison, Outcome
- PECOS stands for Population/Problem, Exposure, Comparison, Outcome, Study design
- PICo stands for Problem, phenomenon of Interest, Context (used on qualitative questions)
PCC
Definition and purpose
The PCC framework is useful for questions that are broad or reviewing qualitative research.
The PCC framework is recommended by the JBI Scoping Review guidelines (11.2.2 Developing the title and question).
PCC stands for:
- Population or Problem
- Concept
- Context
Scenario
The government is funding a review into measuring the experiences of adults with atrial fibrillation. They're particularly interested in the impact atrial fibrillation has on quality of life. You want to apply for the grant and start planning your methodology.
Research question
What tools are available to measure quality of life (C) in adults with atrial fibrillation (P) in Australia (C)?
Framework and scenario matching
| Element | Definiton | Scenario |
|---|---|---|
| P (population/problem) | Who is the population of interest? OR What is the problem of interest? |
Adults with atrial fibrillation |
| C (concept) | What is the concept of interest? | Quality of life measurement |
| C (context) | What is the context? E.g. Geographic, Setting, etc. | Australia |
Example research paper
Risom, S. S., Nørgaard, M. W., & Streur, M. M. (2022). Quality of life and symptom experience measurement tools in adults with atrial fibrillation: a scoping review protocol. JBI evidence synthesis, 20(5), 1376-1384.
PEO
Definition and purpose
The PEO framework is useful for epidemiological questions about exposure to an event or an illness.
PEO stands for:
- Population and their problems
- Exposure
- Outcomes or themes
Scenario
Recently, there have been increasing cases of laryngeal cancer amongst people who work as stonemasons. The research team seeks to examine the literature to determine whether there is an association between exposure to dust through stonemasonry and developing silicosis.
Research question
Is there an association for people who work as stonemasons (P) between occupational exposure to silica dust (E) and laryngeal cancer (O)?
Framework and scenario matching
| Element | Definiton | Scenario |
|---|---|---|
| P (population and their problem) | Who is the population of interest? AND What is the problem of interest? |
People who work as stonemasons |
| E (exposure) | What is the exposure event or exposure disease? | Silica dust |
| O (outcomes or themes) | What is the result or outcome of interest? OR What themes are of interest? |
Laryngeal cancer or silicosis |
Example research paper
Chen, M., & Tse, L. A. (2012). Laryngeal cancer and silica dust exposure: A systematic review and meta‐analysis. American journal of industrial medicine, 55(8), 669-676.
SPICE
Definition and purpose
The SPICE framework is useful for questions evaluating the results of a service, project, or intervention.
SPICE stands for:
- Setting
- Perspective
- Intervention
- Comparison
- Evaluation
Scenario
You are wanting to design a new program to support the well-being of people living with spinal cord injury, but first, you want to know what other programs have been developed, and how they’ve been received by the program participants.
Research question
From the perspective of community-based (S) people living with spinal cord injury (P), what is the impact of well-being interventions (I) on their own quality of life (E)?
Framework and scenario matching
| Element | Definiton | Scenario |
|---|---|---|
| S (setting) | What is the setting? | Community |
| P (perspective) | Whose perspectives and experiences are of interest and what are they? | People living with a spinal cord injury |
| I (intervention) | What is the intervention of interest? | Well-being |
| C (comparison)* | What are you comparing the intervention to? | No comparison |
| E (evaluation) | What is the result? | Impact of well-being interventions on people with a spinal cord injury |
*Note: There may not always be a comparison element.
Example research paper
Simpson, B., Villeneuve, M., & Clifton, S. (2022). The experience and perspective of people with spinal cord injury about well-being interventions: a systematic review of qualitative studies. Disability and rehabilitation, 44(14), 3349-3363.
SPIDER
Definition and purpose
The SPIDER framework is useful to help frame qualitative questions or those involving mixed methods research.
SPIDER stands for:
- Sample
- Phenomenon of Interest
- Design
- Evaluation
- Research type
Scenario
You're beginning a research degree in which you want to investigate barriers to nurses offering cross-cultural care. You want to know whether any studies were undertaken from the perspectives of nurses before you start your research.
Research question
What are the perspectives (E) of nurses and nursing students (S) of their experiences in delivering transcultural care (PI)?
Framework and scenario matching
| Element | Definiton | Scenario |
|---|---|---|
| S (sample) | Who is the group of interest? | Nurses or nursing students |
| PI (phenomenon of interest) | What is the researcher interested in? (e.g. behaviours, experiences) | Experiences of transcultural care |
| D (design) | What study designs will be included in the review? | Interview, survey, focus groups, questionnaires |
| E (evaluation) | What are the outcomes of the research? (e.g. perspectives) | Themes in nurse perspectives |
| R (research type) | What type of research will be included in the review? | Qualitative, mixed methods |
Example research paper
Shahzad, S., Ali, N., Younas, A., & Tayaben, J. L. (2021). Challenges and approaches to transcultural care: An integrative review of nurses' and nursing students' experiences. Journal of Professional Nursing, 37(6), 1119-1131.
Activity: Match the framework to the question
Reviews can be exploring the same topic from different perspectives and for different reasons.
Below are three reviews looking at the topic of counselling for children. Think about and select the appropriate framework that has been used to frame each research question.
Activity overview
This interactive activity shows a series of review questions in a random order. The user needs to identify which review question framework has been applied appropriately to frame each review question.
Read the review questions below and think about which review question framework has been applied to frame it.
First review question
In school aged children with anxiety how effective is online counselling compared with in-person counselling in reducing panic attacks?
Activity: select the framework used to frame the review question
Choose from the frameworks below:
- PCC
- PEO
- PICO
- SPICE
- SPIDER
Answer to first review question
The PICO framework has been used to frame this review question based on its key elements:
In school aged children with anxiety (P) how effective is online counselling (I) compared with in-person counselling (C) in reducing panic attacks (O)?
Second review question
What are the experiences of school aged children with anxiety undergoing online counselling in rural Australia?
Activity: select the framework used to frame the review question
Choose from the frameworks below:
- PCC
- PEO
- PICO
- SPICE
- SPIDER
Answer to second review question
The PCC framework has been used to frame this review question based on its key elements:
What are the experiences of school aged children with anxiety (P) undergoing online counselling (C) in rural Australia (C)?
Third review question
Children in rural Australia often lack access to in-person counselling services. From the perspective of their parents, how effective is online counselling compared with in person counselling?
Activity: select the framework used to frame the review question
Choose from the frameworks below:
- PCC
- PEO
- PICO
- SPICE
- SPIDER
Answer to third review question
The SPICE framework has been used to frame this review question based on its key elements:
Children in rural Australia (S) often lack access to in-person counselling services. From the perspective of their parents (P), how effective (E) is online counselling (I) compared with in person counselling (C)?
Remember and reflect
Key takeaway
A framework is a useful tool in shaping your review topic into a research question. A framework does this by identifying key elements from your review topic. These key elements can then be used when developing your search to address your research question.
Consider
Before beginning your search take a moment to clarify your research question. As it's important to have a clear and answerable research question at the beginning of your review process. If later in the review process your question changes, the risk of bias in your review increases. It may even require you to start the review process again from the beginning.