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Systematic Reviews

General procedures to help guide researchers through the elements of a systematic review

Develop Research Question

Developing a workable research question for a systematic review takes some consideration. This question will be refined as you conduct exploratory research to identify other systematic reviews on your research question or in the initial phase of your literature review. There are several research question frameworks to choose from. Here are just a few:

BeHEMoTh (questions about theories)

Behavior of interest
Health contest (service, policy, intervention)
Models or theories

CHIP (psychology, qualitative)


COPES (social work, health care, nursing)

Client oriented
Evidence Search

ECLIPSE (management, services, policy, social care)

Expectation (what are you looking to improve/change? To increase access to wireless internet in hospitals)
Client (patients & families)
Location (hospitals)
Impact (clients have easy access to free internet)
Professionals (who is involved in improving this service? IT, hospital administration)
Service (what kind of service is this? provision of free wireless internet to patients)

PEO (Qualitative)


PICO (clinical/PH)

Patient/Population (patients with cellulitis)
Intervention (once-daily IV cephazolin and oral probenecid)
Comparison (with what - twice-daily IV Cephazolin)
Outcome (shorter recovery time)

PICO+ (Occupational Therapy)

PICO elements above
Context, patient values, preferences, or type of study

SPICE (social sciences)

Setting – Where? (hospital waiting rooms)
Perspective – For whom? (hospital outpatients)
Intervention - what will you be trying? (therapy dog visits)
Comparison – compared with what? (no therapy dog visits)
Evaluation – with what result? (reduced anxiety)

SPIDER (qualitative research, focusing less on interventions and more on study design and "samples" rather than populations)

Sample - (young parents)
Phenomenon of Interest - (antenatal education)
Design - (survey)
Evaluation - (experiences)
Research Type - (qualitative)

Is your question suited for a systematic review?

While a systematic review is considered the highest form of evidence, not all questions are suited to a systematic review. A question that is well suited to this methodology is:

  • A specific question or patient problem where the results allow you to do direct comparison. 
  • Narrow enough that identifying and reviewing all of the relevant literature is possible. An extremely broad question (e.g. examining pain management and assessment) may be more suited to a general literature review or evidence mapping.
  • Broad enough that you will be able to find some relevant literature. An extremely narrow topic (e.g. an examination of a very small subset of a population) or one that is examining a very new treatment or concept may not return enough relevant literature to be able to draw meaningful conclusions.
  • A question with a multi-stepped intervention, or one in which different elements of an intervention may or may not be included in each study might be more suited to a decision modeling approach.

For examples of other research methods that might be better suited for your work, visit here.