AN INTRODUCTORY GUIDE TO

PUTTING RESEARCH INTO PRACTICE

2. Defining the Research Question
Kate Springett & Jackie Campbell

Getting the question right is absolutely crucial to the rest of the research
process. This is obvious as getting the right answer to the wrong
question is going to waste an awful lot of time and resources. However,
the main problem is not asking the wrong question, but not properly
defining the right question. This article assumes you have identified a
general area that you are interested in researching and will give
guidance on how to take that idea and shape it into a researchable
question.
This process should be the same irrespective of whether you are
searching existing literature for the answer, or preparing to design and
conduct your own research study. This stage is neither simple nor quick.
It can take days, weeks or sometimes months, depending upon the
complexity of the problem, to arrive at a clear, concise and accurate
question. It is not worth rushing; time spent now will save irritation and
frustration later.
What is a Research Question? clinical study, you need an RQ; if you want
When you have a problem to solve – a to explore patients’ perceptions of a
question for which an answer is needed – management approach, you need an RQ;
then you have to do some work to find whether your planned work is likely to use
that answer. Sometimes this information a qualitative or quantitative approach, you
is available in the literature; sometimes need an RQ.
you need to start from scratch, as no or An RQ acts also as an ‘aide memoire’.
little information exists. It helps you keep focused on your area of
Correspondence to: Either way you need to spend a bit of enquiry, which is particularly helpful
Dr Kate Springett, Head of Department of Allied time deciding what the problem is, what it when searching the literature and if you
Health Professions, Canterbury Christ Church is that you really want to find out and find you get sidetracked easily.
University, North Holmes Road, Canterbury, Kent, what the nature of the problem is. Turning The key to defining an RQ is focus. The
CT1 1QU. Email: [email protected] this into a non-biased and precise question end product needs to be a specific query
– a Research Question (RQ) – helps in that is explicit in what it is looking for. The
Professor Jackie Campbell, School of Health, The working through how to answer it. process of defining the question is
University of Northampton, Boughton Green Road, If you are doing a literature review, you therefore essentially one of taking a broad
Northampton NN2 7AL. need an RQ; if you want to find out about topic area and narrowing it down until you
E-mail: [email protected] the efficacy of an intervention through a have a question that can be answered fully.
 Feature

P
What is the problem that you have come across in practice and need an
answer for? What is the patient group or population of people who are
How much focus is required depends to
relevant to the area you need to look into?
some extent on how much research you are
intending to do to answer it.
Given unlimited time and resources, a
question such as ‘What is the best Tease this information out; break it into sub-units -
management regime for metatarsalgia?’ what are you interested in? Pick out key words and
may be answerable, but it would take a phrases that capture this and turn into questions
long time to research all possible
treatments, for all possible populations of
patients. In doing so, you would probably
break the question down into bite-sized
chunks such as ‘How effective is a
conservative approach compared with I
surgical intervention for the most What do you need to do with your patients/population, or involve
common cause of metatarsalgia in yourself with, to find out the nature of, or answer to, the problem? What
adults?’. These chunks are effectively just information do you want to capture? What intervention do you want to
better defined RQs. investigate? What is it that you want to assess and diagnose or
Once you have decided upon the RQ, evaluate? What is it that you want to observe?
you can then choose which research
approach (qualitative, quantitative or
both) is most appropriate.
Keep asking yourself questions to help you identify
Additional components included in the
and refine what it is that you want/need to find
process of focusing the question may
out. Include the points you arrive at in your
include:1
prototype RQ.
● the study designs in which you are
interested (e.g. randomised controlled
trials)
● the context in which relevant studies
have been undertaken, or whether
there are factors that will limit its C
applicability to the question being Are there comparisons to be made, differences to establish?
asked Is monitoring all that is needed? Do you expect themes or groups of
● language restrictions (e.g., English only characteristics to emerge? e.g. from observation? This section may not
- note potential for language bias) be relevant to your plans.
● any date restrictions on the period the
literature review will cover (e.g., if
updating an existing review). Depending upon what you need and plan to do, so
your prototype RQ needs to reflect this. Has your
The PICO approach RQ captured all components so far?
One approach to limiting the scope of the
topic area is to use the PICO framework.
Although this approach was developed
around Evidence-Based Medicine,2 and
was therefore designed for clinical studies,
it can be adapted to any research context. O
It is an adapted version that is used here. What outcome(s) is relevant? What is it that you will be measuring,
observing, assessing?

Try writing out your question. After a few days,

does it seem to you to be the right question? Tell
others your question. Do they understand what you
want to get at? If not, re-word and refine.

Using comments and returning back to your

Figure 1: Using the PICO approach to problem, have you covered all the points you need in
defining a research question. your prototype RQ? If not, re-word and refine further.

P patient, population, problem

I intervention or exposure
C comparison Does the RQ indicate precisely the required components
O outcome without bias? Yes - you have defined your RQ.
RQ = research question

November 2006 PodiatryNow 27

Feature

● P: Patient, Population or treatment or management approach in Outcome post op pain, regrowth, healing
Problem your prototype RQ. rate, satisfaction
● What are the characteristics of If you plan to evaluate patient data, RQ: Is sodium hydroxide a viable
the patient or population? there may be an audit process (e.g. alternative to phenol for nail matrix
● What is the condition or disease annual review) that you plan to use and ablation?
you are interested in? this needs to be included within your RQ.
● I: Intervention or exposure To explore patients’ commentaries, your Example 2
● What do you want to do with approach to finding out this information General nature/area of problem: with the
this patient/population (e.g. may be through interview or a focus NSF for Older People, we need to find a
treat, diagnose, observe)? group, and this also needs to be reflected way of targeting our ‘at-risk’ population.
● C: Comparison within your RQ. Whatever you intend, How can we do this?
● What is the alternative to the include this in your question. Population people aged 75 years and over
intervention (e.g. placebo, Intervention annual foot health
different drug, surgery)? C – comparison monitoring
● O: Outcome Oval C (and sub-oval) asks you to Comparison no monitoring
● What are the relevant outcomes consider if there are additional things you Outcome effectiveness of health check
(e.g. morbidity, death, want or need to include. Do you want to tool for diagnosis of high-risk podiatric
complications)? compare treatments? If so, you will need conditions + no professional foot care
to include relevant words/phrases within RQ: Can an annual foot health check for
Using the PICO approach your prototype RQ along with the the over 75s detect high-risk conditions
Figure 1 is a step-by-step guide, adapted treatment you plan as a comparison. If that would otherwise be missed?
from Ref 2, to help you refine, define and there are no comparisons to be made, you
focus the problem you have come across will still need to include within your RQ Example 3
and need to answer and to turn it into an that you plan to monitor uptake of General nature/area of problem: outcome
RQ. Allow time for this development. services over time, for example. measures tend to not to capture the
Outline examples are given at the end of It may be that you plan to explore impact of RA on patients’ daily lives in a
this section. patients’ perceptions around their health, way that has a patient focus, but there is
but need to do this in different contexts limited information in the literature about
P – patient, population or problem or times of disorder onset; this what it is that worries people with RA as
Starting at the beginning with the contents information needs including within your far as their feet are concerned. How can
of big oval ‘P’ and related smaller oval, question. It may be that this section is we find this out?
capture your thoughts on paper. What is not relevant to your study at all, in which Population people with RA
the nature of the problem you have come case leave it out! Problem nature of concerns
across and need an answer for? Intervention interview, focus group
For a complex area or one you cannot O – outcome Comparison none, themes describing
see your way through, some people find Oval O and sub-ovals encourage you to nature of concerns expected to develop
highlighting different written thoughts in include in your RQ what the outcome is Outcome identification of a range of
different colours helps, some draw spider that you will be measuring or exploring. If issues e.g. anxiety, uncertainty, frustration
diagrams (mind maps) to show links, centred around a clinical study you may RQ: what is the nature of concerns
whilst others like cutting and pasting to be interested in outcomes including time people with RA have relating to their
show links. (e.g. time to healing), whether the feet and mobility?
Next, discard written thoughts that condition has resolved, costs of the
seem irrelevant, and link other thoughts interventions, patients’ perceptions of the Conclusion
together; what are the main points, the benefit of the intervention, etc. Following a structured process in
key components, or sub-units that strike Now you have included all the parts of developing an RQ means that you do not
you? Try turning these into questions. your RQ, it is again time to leave what miss out stages of thinking. After a while,
Leave what you have written for a few you have written for at least two days. this step-by-step method becomes second
days, return to it with a fresh eye and Returning with a fresh eye, does your RQ nature and you will not realise you are
discard those questions that seem wrong say what you wanted it to say? Try it out going through these stages when
or do not seem to fit in with what you with colleagues. Do they understand it? If developing an RQ.
want to find out. Using the remaining not, re-word and refine and you will Nevertheless, you will still need to
outline question(s), find out if other arrive at your final RQ. allow time for this stage of the research
people understand them; if not it’s ‘back process. It is an important one as a
to the drawing board’. Examples focused RQ is essential to the research
that follows.
I – intervention or exposure Example 1
Moving onto the big oval ‘I’ and sub-oval, General nature/area of problem: We use References
takes you to including in your prototype phenol for nail matrix ablation, is this 1. Booth A & Fry-Smith A, Developing the
RQ note of what you must do to find out really OK, the best way and the best research question. In: Etext on Health
what you want to find out. Use the substance to use? Technology Assessment (HTA) Information
Resources, 2003.
reading you have done in this area to help Population people with ingrowing toe nails
http://www.nlm.nih.gov/nichsr/ehta/chapte
specify what this is. Intervention total or partial nail ablation r2.html (last accessed July 2006).
You may want to look at treatments for using NaOH 2. Richardson WS & Wilson MC, On questions,
a particular condition, in which case you Comparison total or partial nail ablation background and foreground. Evidence Based
will need to state the intervention, using phenol Healthcare Newsletter 1997; 17: 8-9.

28 PodiatryNow November 2006