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Search concept tools

PICO and other tools for developing research questions and search concepts

A variety of tools are listed in alphabetical order that can be used to formulate your research question and identify possible search concepts for your literature search. As a rule of thumb pick the 2-4 concepts which are most simple to search for.*

BeHEMoTh - identification of theories for realist synthesis questions

Be Behaviour of interest

H Health context (the service, policy, programme or intervention)

E Exclusions (for reviewers to exclude non theories)

MoTh: Models or Theories

Booth, A. and Carroll, C. (2015), Systematic searching for theory to inform systematic reviews: is it feasible? Is it desirable?. Health Info Libr J, 32: 220–235. doi:10.1111/hir.12108

CLIP –Health service management questions

C Client – at whom is the service aimed?

L Location – where is the service sited?

I Improvement – what do you want to find out?

P Professional – who is involved in providing/improving the service?

CMO or CIMO - Realist Synthesis questions

ECLIPS(E) – Health service management questions

Expectation—what does the search requester want the information for (the original ‘I’s)?

Client Group.


Impact—what is the change in the service, if any, which is being looked for? What would constitute success? How is this being measured?


Service—for which service are you looking for information? For example, outpatient services, nurse-led clinics, intermediate care.

Wildrige V & Bell L. How CLIP became ECLIPSE: a mnemonic to assist in searching for health policy/management information; HILJ 2002;19(2)113-5 

MIP – Medical ethics questions

M Methodology  e.g. in-depth interviews or questionnaires

I Issues e.g. Healthcare Rationing or  end-of-life decision-making

P Participants e.g. physicians or patients

Strech D, Synofzik M, Marckmann G. Systematic reviews of empirical bioethics. J Med Ethics 2008;34:472-477  

PerSPEcTiF - Qualitative reviews

Per Perspective


Phenomenon of interest/problem


(C) (optional comparison)

Ti Time/Timings


Booth A, Noyes J, Flemming K, Moore G, Tuncalp O, Shakibazadeh E. Formulating questions to explore complex interventions within qualitative evidence synthesis. BMJ Glob Health. 2019;4(Suppl 1):e001107.


PICO – Reviews of interventions for health

P Patient or population

I Intervention

C Comparator

O Outcomes

Richardson W S, Wilson M C, Nishikawa J, & Hayward R S A.The well-built clinical question: A key to evidence-based decisions. ACP Journal Club 1995;123 A12-13.

Nb add ‘S’ on end if study type is significant, a ‘C’ if context is significant or 'T' for timeframe

SPICE – Social science questions

(designed for librarian research questions)

S Setting – Where? In what context?

P Perspective – For who?

I Intervention (Phenomenon of Interest)– What?

C Comparison – What else?

E Evaluation – How well? What result?

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

SPIDER – Qualitative evidence synthesis

*With thanks to Linda Mace-Michalik (The Library, Roseberry Park Hospital, TEWV NHS FT) for distributing her compilation of alternatives to the PICO framework