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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

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

C - Client Group

L - Location

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

P - Professionals

S - 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

S - Setting

P - Phenomenon of interest/problem

- Environment

(C) - (optional comparison)

Ti - Time/Timings

F - Findings

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

PIRD - Diagnostic test accuracy questions

PROGRESS - Health inequality questions

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