Wednesday, August 30, 2023

How to Formulate a Research Question: A Guide Incorporating the FINER, PICOTS, and PECO Frameworks



 Abstract


Crafting a cogent and pertinent research question is fundamental to the success of any scientific inquiry. This central query shapes the design, methodology, and objectives of the research. Through an analysis of the FINER, PICOTS, and PECO frameworks, this article aims to offer a comprehensive guide for the effective formulation of research questions (Richardson et al., 1995; Hulley et al., 2013).


 Introduction


The dictum, "A well-defined problem is half-solved," encapsulates the importance of articulating a precise research question. A question that is both specific and germane has the power to steer the entire course of a research investigation. The present article elucidates the principles and methodologies underpinning the construction of research questions, with an emphasis on the FINER, PICOTS, and PECO frameworks (Richardson et al., 1995).


 The FINER Framework


 The Fundamentals of FINER


The acronym FINER stands for Feasible, Interesting, Novel, Ethical, and Relevant. This framework serves as a heuristic tool that assists researchers in scrutinizing both the practical and academic merits of their proposed research questions (Hulley et al., 2013).


 Feasibility


Feasibility pertains to whether the research question can be answered given the constraints of time, resources, and technical expertise. For instance, a longitudinal study spanning a decade and requiring a large sample size may not be viable for a short-term research project.


 Interest


The notion of 'Interest' implies that the research question should captivate the attention of both the scientific community and relevant stakeholders. A question lacking in intrigue is unlikely to galvanize academic or public interest.


 Novelty


Innovative research questions contribute new insights or perspectives to existing scholarly literature. They should strive to explore uncharted territory rather than merely replicating established studies.


 Ethical Considerations


Ethical rigor is indispensable in the formulation of any research question. The proposed inquiry must uphold ethical standards, minimizing risks and ensuring the dignity and rights of participants are respected.


 Relevance


The criterion of 'Relevance' mandates that the research question aligns with pressing issues in the field and holds significance for key stakeholders, such as clinicians, policymakers, and patients.


 The PICOTS Framework


 Unpacking PICOTS


PICOTS is an acronym denoting Population, Intervention, Comparator, Outcome, Time Frame, and Setting. This framework is especially pertinent for framing questions in clinical research, guiding the specificity of each constituent element (Hulley et al., 2013).


 Population


The 'Population' category delineates the demographic or clinical characteristics of the subjects under study. For example, in research investigating a new drug for diabetes, the population could be specified as "adults diagnosed with Type 2 diabetes."


 Intervention


This segment outlines the specific treatment or intervention being examined. In a diabetes-related study, this could refer to "administration of Drug X."


 Comparator


The 'Comparator' is the benchmark against which the intervention is measured. It could be a placebo or current standard care, for instance.


 Outcome


The 'Outcome' specifies what exactly will be measured to assess the efficacy of the intervention. In our hypothetical diabetes study, this could be "alterations in fasting glucose levels."


 Time Frame


This criterion establishes the study duration, whether it be a 6-month clinical trial or a two-year longitudinal study.


 Setting


The 'Setting' identifies the location of the study, such as a hospital, community clinic, or laboratory.


 Intersecting FINER and PICOTS


The FINER framework functions as a vetting mechanism for the research questions formulated through the PICOTS framework. For instance, one might generate a research question like, "Does the administration of Drug X in adult patients with Type 2 diabetes, compared to a placebo, produce significant changes in fasting glucose levels over a 6-month period in a clinical setting?" Subsequently, the FINER criteria can be applied to evaluate its soundness and pertinence.


 The PECO Framework


 An Overview of PECO


PECO, standing for Patient, Exposure, Comparison, and Outcome, is another framework commonly deployed in formulating questions for observational studies (Richardson et al., 1995).


 Patient


This criterion resembles the 'Population' category in PICOTS and specifies the group under study.


 Exposure


'Exposure' identifies the variable or condition being examined. In a study probing the relationship between dietary habits and cardiovascular diseases, "exposure" might refer to a high-fat diet.


 Comparison


This variable denotes the control or standard against which the exposure is evaluated, perhaps a low-fat diet in the case of a study on cardiovascular diseases.


 Outcome


The 'Outcome' is the measurable effect or endpoint, such as the incidence rate of cardiovascular diseases in the aforementioned example.


 Analogies for Elucidation


 FINER as a Quality Assurance Mechanism


Consider the FINER framework as a quality filter for coffee. The choice of coffee beans (the initial idea) significantly influences the end product. However, it is the filter (FINER) that refines the brew, allowing only the best aspects to be part of the final cup.


 PICOTS as a Culinary Recipe


The PICOTS framework can be likened to a culinary recipe. Each element (P, I, C, O, T, S) must be precisely measured and included to create a well-crafted research question (dish).


 PECO as an Observational Lens


The PECO framework serves as a telescope, enabling researchers to focus on specific variables (celestial bodies) in the expansive realm of a research field, thereby making observations that are both meaningful and specific.


 Conclusion


Formulating a research question is a complex, non-linear undertaking that necessitates the judicious application of frameworks such as FINER, PICOTS, and PECO. These frameworks serve as invaluable tools for researchers, aiding in the articulation of research questions that are clear, focused, and meet criteria for feasibility, novelty, ethical soundness, and relevance (Richardson et al., 1995; Hulley et al., 2013).


CriteriaGood ExampleBad ExampleAnalysis
FINERWhat is the impact of exercise on mental health among adults?Is exercise good?The good example is specific, asking about the "impact of exercise on mental health among adults," whereas the bad example is vague and lacks specificity.
Does a Mediterranean diet reduce the risk of cardiovascular diseases in men over 50?Does eating healthy prevent diseases?The good example is feasible and relevant, focusing on a specific diet and a specific age group. The bad example is too broad and vague.
What are the ethical implications of gene editing in human embryos?Is gene editing ethical?The good example is novel and focuses on a specific area of ethical concern. The bad example is too broad and does not specify the context.
How do treatment methods for acute myeloid leukemia (AML) affect the quality of life in pediatric patients?What cures cancer?The good example is feasible, focusing on a specific type of leukemia and a specific population (pediatric patients). The bad example is overly broad and unfeasible.
How does air pollution in urban areas contribute to respiratory diseases?Is air pollution bad?The good example is relevant and specific, focusing on "air pollution in urban areas" and its contribution to "respiratory diseases." The bad example is too general.
PICOTSIn adult patients with Type 2 diabetes, does treatment with Drug X, as compared to a placebo, result in significant changes in fasting blood sugar levels over a 6-month period in a hospital setting?Does Drug X help with diabetes?The good example uses the PICOTS framework to be highly specific about each element of the study. The bad example lacks detail and specificity.
In post-menopausal women, how does calcium supplementation compared to placebo affect bone mineral density over a 12-month period?Does calcium help bones?The good example is specific about the population, intervention, comparator, outcome, time frame, and setting. The bad example lacks these details.
In patients with chronic insomnia, does cognitive behavioral therapy (CBT), compared to pharmacological treatment, improve sleep quality over a 3-month period?What treats insomnia?The good example is comprehensive and specific, providing a clear roadmap for a potential study. The bad example is too vague.
Among smokers aged 18-30, does the use of nicotine patches compared to behavioral therapy result in higher cessation rates after one year?How do you quit smoking?The good example is specific about the population and uses a comparator and a measurable outcome. The bad example is not specific enough for research.
For ICU patients with sepsis, does the early initiation of broad-spectrum antibiotics, compared to delayed treatment, reduce mortality rates within 30 days?Do antibiotics help in the ICU?The good example is highly specific, identifying the population, intervention, comparator, outcome, time frame, and setting. The bad example is too vague and lacks specificity.



 References


- Richardson, W.S., Wilson, M.C., Nishikawa, J., Hayward, R.S. (1995). The well-built clinical question: a key to evidence-based decisions. *ACP J Club*, 123(3), A12-3. PMID: 7582737.

- Hulley, S.B., Cummings, S.R., Browner, W.S., Grady, D., Newman, T.B. (2013). *Designing Clinical Research*. 4th ed. Philadelphia: Lippincott Williams & Wilkins.