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Formulate a review question

Page history last edited by Pierre PLUYE 8 years, 2 months ago

In mixed studies reviews, there may be one qualitative question, or one quantitative question, or a qualitative and a quantitative question (see examples in the table below).

  • Typical qualitative questions are ‘what?’, ‘how?’, and ‘why?’.
  • Typical quantitative questions concern the incidence and prevalence of a problem or a risk factor, and the likelihood and significance of the association between factors and outcomes. 


For example, a question on the effectiveness of an intervention is traditionally framed using all elements of the PICO structure, or any of its variant forms such as PICOS or PICOT (Centre for Reviews and Dissemination, 2009; O'Connor, Green and Higgins, 2008; Rios, Ye and Thabane, 2010; Stillwell, Fineout-Overholt, Melnyk and Williamson, 2010). These letters stand for: 

  • P: population or problem
  • I: intervention or issue of interest (e.g., exposure)
  • C: comparator
  • O: outcome
  • S: study design or setting (e.g., context)
  • T: timing of outcome assessment


For qualitative and mixed studies reviews, other frameworks for structuring questions have been proposed such as: 

  • SPICE: Setting, Perspective, Intervention, Comparison, and Evaluation (Joanna Briggs Institute, 2011)
  • SPIDER :  Sample, Phenomenon of Interest, Design, Evaluation, and Research type (Cooke et al., 2012)


Tip: You can use the attached checklist(s) for (self)assessing qualitative and quantitative questions.



  • Centre for Reviews and Dissemination (2009). Systematic Reviews: CRD's guidance for undertaking reviews in health care. York, UK: Centre for Reviews and Dissemination, University of York.
  • Cooke A, Smith D, Booth A (2012). Beyond PICO: the SPIDER tool for qualitative evidence synthesis. Qualitative Health Research, 22(10), 1435-1443.
  • Joanna Briggs Institute (2011). Joanna Briggs Institute Reviewers’ Manual 2011 Edition. Adelaide: Joanna Briggs Institute.
  • O'Connor D, Green S, Higgins JPT (2008). Defining the review question and developing criteria for including studies. In Cochrane Handbook for Systematic Reviews of Interventions (pp. 81-94): John Wiley & Sons, Ltd.
  • Rios L, Ye C, Thabane L (2010). Association between framing of the research question using the PICOT format and reporting quality of randomized controlled trials. BMC Medical Research Methodology, 10(1), 11.
  • Stillwell SB, Fineout-Overholt E, Melnyk BM, Williamson KM (2010). Evidence-based practice, step by step: asking the clinical question: a key step in evidence-based practice. American Journal of Nursing, 110(3), 58-61.



Designs (see section on synthesis) Example of review questions:  Questions adapted from: 
Convergent qualitative Qualitative question (PI): What are the (types of or key) processes of making shared decisions with palliative care patients? Bélanger et al. (2011)
Convergent quantitative

Quantitative question (PIT): What are the frequencies of the different paradigms and methods used in negotiation research studies in 1964-1993 compared to 1994-2004? 

 The objective was to identify the shifts that occurred in the negotiation research literature.

Buelens et al. (2008)
Sequential explanatory  Quantitative question (PICO): For pregnant women, do diet and physical activity interventions prevent excessive gestational weight gain compared to no intervention (e.g., routine prenatal care)?


Followed by a qualitative question (PIO):  What are the viewpoints of pregnant women with regard to types of factors associated with the implementation and outcomes of diet and physical activity interventions preventing excessive gestational weight gain?

Campbell et al. (2011)
Sequential exploratory  Qualitative question (PI): What are the views of chronic obstructive pulmonary disease (COPD) patients on the barriers and facilitators influencing the attendance to pulmonary rehabilitation?


Followed by a quantitative questions (PIO):  Is there any association between the level of up-take and completion of pulmonary rehabilitation by COPD patients and the identified barriers and facilitators ?

Keating et al. (2011)



  • Bélanger E, Rodriguez C,  Groleau D. (2011). Shared decision-making in palliative care: a systematic mixed studies review using narrative synthesis. Palliative Medicine, 25(3), 242-261.
  • Buelens M, Woestyne M, Mestdagh S,  Bouckenooghe D. (2008). Methodological issues in negotiation research: A state-of-the-art-review. Group Decision and Negotiation, 17(4), 321-345.
  • Campbell F, Johnson M, Messina J, Guillaume L,  Goyder E. (2011). Behavioural interventions for weight management in pregnancy: A systematic review of quantitative and qualitative data. BMC Public Health, 11.
  • Keating A, Lee A,  Holland AE. (2011). What prevents people with chronic obstructive pulmonary disease from attending pulmonary rehabilitation? A systematic review. Chronic Respiratory Disease 8(2), 89-99. 

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