Skip to Main Content

Finding Evidence

Formulating your question

The first step in the evidence-based practice process is to formulate a clinical question. The clinical question should be relevant to the patient or the problem and constructed to help you search for an answer. There are question frameworks which can help you to: 

  • put together the parts of the clinical question
  • identify the key concepts that need to be in articles that will help answer the question
  • formulate your search strategy.
Framework Definition
PICO Population/problem - Intervention - Comparison - Outcome
PICOS Population/problem - Intervention - Comparison - Outcome - Study design
SPIDER Sample - Phenomenon of interest - Design - Evaluation - Research type
PEO Population - Exposure - Outcome
PICO For Evidence Based Medicine by University of Sydney Library

Gathering keywords

You need to gather a list of keywords, synonyms and related words for each concept in your question (population / intervention etc). For each concept, consider including: 

  • Synonyms e.g. pressure injuries / pressure ulcers / bed sores
  • Formal wording and common usage e.g. myocardial infarction / heart attack
  • Australian and international spelling  e.g. aging / ageing
  • Australian and international usage e.g. emergency department / emergency room / casualty / accident and emergency / A&E
  • The full medical term and the common abbreviation e.g. chronic obstructive pulmonary disease / COPD
  • Opposites e.g. vitamin d supplement / deficiency 

Further reading

Cooke, A., Smith, D., & Booth, A. (2012). Beyond PICO: The SPIDER tool for qualitative evidence synthesis. Qualitative Health Research, 22(10), 1435-1443. https://doi.org/10.1177/1049732312452938

Fineout‐Overholt, E., & Johnston, L. (2005). Teaching EBP: asking searchable, answerable clinical questions. Worldviews on Evidence‐Based Nursing, 2(3), 157-160. https://doi.org/10.1111/j.1741-6787.2005.00032.x

Gallagher Ford, L., & Melnyk, B. M. (2019). The Underappreciated and Misunderstood PICOT Question: A Critical Step in the EBP Process. Worldviews on Evidence-Based Nursing, 16(6), 422–423. https://doi.org/10.1111/wvn.12408

Windish, D. (2013). Searching for the right evidence: how to answer your clinical questions using the 6S hierarchy. BMJ Evidence-Based Medicine, 18(3), 93-97. http://dx.doi.org/10.1136/eb-2012-100995