Chapter 2: Determining the scope of the review and the questions it will address

Rationale of  With reference to the FINER criteria, the research questions should be:
A Well- Feasible  Asks a question that the author team is capable of
Formulated addressing using the evidence available.
Research Interestin  Authors must be interested with the research question so that
Question g they have sufficient commitment to see the work through to
its conclusion.
Novel  A novel research question will address a genuine gap in
knowledge.
 Authors should check for pre-existing reviews in the
published research literature and also for ongoing reviews in
the PROSPERO register of systematic reviews before
beginning their own review.
Ethical  Research questions are often not value-neutral, and the way
that a given problem is approached can have political
implications which can result in, for instance, the widening
of health inequalities (whether intentional or not).
 Authors should consider the potential impact on
disadvantaged groups of the interventions that they are
investigating on disadvantaged groups, and whether socio-
economic inequalities in health might be affected depending
on whether or how they are implemented.
Relevant  Authors should ensure that their research question is
relevant to the stakeholders and facilitate the translation of
findings to inform decisions.

Components  The detailed specification of the review question requires consideration of

of Research several key components which can often be encapsulated by the ‘PICO’
Question (Population, Intervention, Comparison(s) and Outcome).
Scope  The questions addressed by a review may be broad or narrow in scope.
(Breadth) of  The scope of a review depends upon the perspectives regarding a question’s
Research relevance and potential impact, the supporting theoretical, biologic and
Question epidemiological information, the potential generalisability and validity of
answers to the questions, as well as the available resources.

Broad Scope Review Narrow Scope Review

Advantages  Comprehensive summary  Easy manageability for
of evidence. review team.
 Opportunity to explore  Ease of reading.
consistency of findings,
hence, generalisability
across different
populations.
  Opportunity to explore
consistency of findings
across different
implementations of the
intervention.
Disadvantage  Searching, data
s collection, analysis and
writing may require more
resources.
 Interpretation may be
difficult for readers if the
review is large and lacks
a clear rationale for
including diverse types
of participants or
intervention.
 Evidence may be sparse.
 Unable to explore
whether an intervention
operates differently in
other settings or
populations.
 Unable to explore
whether different modes
of intervention modify
the intervention effects.
 Increased burden for
decision makers if
multiple reviews must
be accessed (e.g. if
evidence is sparse).

Generating  A research priority-setting exercise is a collective activity for deciding

Research which uncertainties are most worth trying to resolve through research.
Question  Using research priority-setting exercises to define the scope of a review
from helps to prevent the waste of scarce resources for research by making the
Priority- review more relevant to stakeholders.
Setting  The results of research priority-setting exercises can be searched in
Exercises electronic databases and websites of relevant organizations (e.g. James Lind
Alliance, World Health Organization, organizations of health professionals
including research disciplines, and ministries of health in different
countries).
 Other sources of questions are often found in ‘implications for future
research’ sections of articles in journals and clinical practice guidelines.
Generating  In the absence of a relevant research priority-setting exercise, or when a
Research systematic review is being conducted for a very specific purpose (i.e. to
Questions inform the development of a guideline), researchers should work with
by relevant stakeholders to define the review question.
Engaging  This is especially important when developing review questions for studying
Stakeholder the effectiveness of health systems and policies. Due to the variability
s between countries and regions, the significance of these differences may
only become apparent through discussion with the stakeholders.
 The stakeholders for a review could include consumers or patients, carers,
health professionals, policy decision makers and others.