Using a framework allows you to structure your question by clarifying the main concepts of your topic you want to focus on. Your topic may not fit perfectly into a framework, just using part of a framework can be sufficient.
The framework you should use depends on the type of topic you will be researching. The most common frameworks are:
Patient, Population or Problem - who and/or what is my question focussed on?
Intervention - what intervention is being considered?
Comparison - what intervention is this being compared with (a comparison is not always necessary)
Outcomes - what do you hope to accomplish, improve or affect?
Example: Alternatives to drugs for controlling headaches in children
P - children
I - alternatives to drugs (complementary therapies? changes to lifestyle?)
C - drugs
O - controlling headaches
There are extensions to the PICO framework available which you can use if your topic has additional concepts:
PICOS- here the S stands for study designs (you can use this framework if you are only interested in examining specific designs of study)
PICOT- here the T stands for timeframe (you can use this framework if your outcomes need to be measured in a certain amount of time e.g. 24 hours after surgery).
PICOC- here the C stands for context (you can use this framework if you are focussing on a particular organisation or particular circumstances)
Patient, Population or Problem- who and/or what is my question focussed on?
Interest- a defined event, experience, activity or process
Context- a setting or distinct characteristics
Example: What are the experiences of patients with pressure sores who receive treatment at home?
P- patients with pressure sores
I- experiences, views, opinions
Co- care in the home
Population - who is my question focussed on?
Exposure - what is the issue I'm interested in?
Outcomes or themes - what, in relation to the issue, do I want to examine?
Example: The daily living experiences of mothers with postnatal depression
E- postnatal depression
O- experiences of daily living/quality of life
Setting - where is the study set e.g. in a specific country, community, in a hospital, in a care home etc.
Perspective - from whose perspective is the study done e.g. the patients, the health professionals., the carers etc.
Intervention - what intervention is being examined?
Comparison - is the intervention being compared with another?
Evaluation - the outcome measures
Example: Attitudes of carers of people with dementia towards reminiscence therapy
S - (United Kingdom? care homes?)
P - carers
I - reminiscence therapy
C - NONE
E - attitudes
Sample - the group of people being looked at, because qualitative research is not easy to generalize, sample is preferred over patient.
Phenomenon of Interest - reasons for behaviour and decisions, rather than an intervention.
Design - the form of research used, such as interview or survey.
Evaluation - outcome measures.
Research type - qualitative, quantitative and/or mixed methods.
Example: Young parents experiences of attending ante-natal education
S - young parents
PI - attendance at ante-natal education classes
D - (interviews? surveys?)
E - Experiences
R - (qualitative studies?)
Expectation - what is the information needed for?
Client Group -who is the information needed for e.g. health managers, GPs, patients
Location - where is the client group or service located
Impact - what is the change in the service, if any, which is being looked for? What would constitute success? How is this being measured?
Professionals - what health professionals are involved in the service?
Service - for which service are you looking for information? For example, outpatient services, nurse-led clinics, intermediate care.
Example: retention of A & E nurses in the NHS
E- to find out retention rates
C- (patients? managers?)
I- retention of staff
S- A & E
Not all topics will fit perfectly into a framework. If this is the case with your topic use only the parts of a framework which do fit.