Difference between Quantitative and Qualitative Research Question- PICO vs. SPIDER


  • Yasir Rehman Canadian Academy of Osteopathy


Expectations, qualitative studies, quantitative studies, research question, PICO, SPIDER


Purpose: The research question, an empirical component of research, is used for conceptualization, methodology selection, and patient recruitment when aiming to answer a complex phenomenon. PICO (patient, intervention, comparison, and outcome) is a commonly employed/used framework for formulating a research question in quantitative studies. The PICO framework does not capture all the components of a qualitative research question thus, PICO may not be a suitable framework. To describe difference between qualitative and quantitative research questions and what are the main components of these questions. 

Methodology: Non-systematic review of qualitative and quantitative studies exploring expectations in preoperative sciatica and or chronic low back pain patients. We compared the research question between qualitative and quantitative studies, using SPIDER and PICO framework.

Findings: We reviewed five qualitative studies, and six quantitative studies that explored expectation in sciatica or chronic low back pain patients undergoing surgical or nonsurgical interventions. Qualitative studies differed from quantitative studies as the former do not test hypotheses, but instead generated them. Qualitative studies are used to explain complex processes such as patients’ perceptions, experiences, attitudes, and opinions. The PICO framework did not capture all the components of a qualitative research question thus, SPIDER should be preferred over the PICO framework.

Discussion: Understanding the difference in qualitative and quantitative research questions will be of particular importance to new researchers and students planning to conduct qualitative research.


. L. Slevitch, "Qualitative and Quantitative Methodologies Compared: Ontological and Epistemological Perspectives," Journal of Quality Assurance in Hospitality & Tourism, vol. 12, no. 1, pp. 73-81, 2011, doi: 10.1080/1528008x.2011.541810.

. A. Strauss and J. Corbin, Basics of qualitative research: Techniques and procedures for developing grounded theory, 2nd ed (Basics of qualitative research: Techniques and procedures for developing grounded theory, 2nd ed.). Thousand Oaks, CA, US: Sage Publications, Inc, 1998, pp. xiii, 312-xiii, 312.

. J. Walker, I. Holloway, and S. Wheeler, "Guidelines for Ethical Review of Qualitative Research," Research Ethics, vol. 1, no. 3, pp. 90-96, 2005, doi: 10.1177/174701610500100304.

. C. Kivunja, "How to Write an Effective Research Proposal for Higher Degree Research in Higher Education: Lessons from Practice," The International Journal of Higher Education, vol. 5, pp. 163-172, 2016.

. S. Mantzoukas, "Issues of Representation within Qualitative Inquiry," Qualitative Health Research, vol. 14, no. 7, pp. 994-1007, 2004/09/01 2004, doi: 10.1177/1049732304265959.

. S. Mantzoukas and M. A. Jasper, "Reflective practice and daily ward reality: a covert power game," Journal of Clinical Nursing, vol. 13, no. 8, pp. 925-933, 2004, doi: https://doi.org/10.1111/j.1365-2702.2004.01008.x.

. M. Sandelowski and J. Barroso, "Reading Qualitative Studies," International Journal of Qualitative Methods, vol. 1, no. 1, pp. 74-108, 2002, doi: 10.1177/160940690200100107.

. K. Mattick, J. Johnston, and A. de la Croix, "How to…write a good research question," The Clinical Teacher, vol. 15, no. 2, pp. 104-108, 2018, doi: https://doi.org/10.1111/tct.12776.

. M. K. Giacomini, "The rocky road: qualitative research as evidence," Evidence Based Medicine, vol. 6, no. 1, p. 4, 2001, doi: 10.1136/ebm.6.1.4.

. M. E. Delost and T. S. Nadder, "Guidelines for Initiating a Research Agenda: Research Design and Dissemination of Results," American Society for Clinical Laboratory Science, vol. 27, no. 4, p. 237, 2014, doi: 10.29074/ascls.27.4.237.

. K. Hammarberg, M. Kirkman, and S. de Lacey, "Qualitative research methods: when to use them and how to judge them," Human Reproduction, vol. 31, no. 3, pp. 498-501, 2016, doi: 10.1093/humrep/dev334.

. J. Agee, "Developing qualitative research questions: a reflective process," International Journal of Qualitative Studies in Education, vol. 22, no. 4, pp. 431-447, 2009, doi: 10.1080/09518390902736512.

. G. Bordage and B. Dawson, "Experimental study design and grant writing in eight steps and 28 questions," (in eng), Med Educ, vol. 37, no. 4, pp. 376-85, Apr 2003, doi: 10.1046/j.1365-2923.2003.01468.x.

. A. Booth, A. O'Rourke, and N. Ford, "Structuring the pre-search reference interview: A useful technique for handling clinical questions," Bulletin of the Medical Library Association, vol. 88, pp. 239-46, 08/01 2000.

. A. Eldawlatly, H. Alshehri, A. Alqahtani, A. Ahmad, F. Al-Dammas, and A. Marzouk, "Appearance of Population, Intervention, Comparison, and Outcome as research question in the title of articles of three different anesthesia journals: A pilot study," (in eng), Saudi J Anaesth, vol. 12, no. 2, pp. 283-286, Apr-Jun 2018, doi: 10.4103/sja.SJA_767_17.

. G. J. Ho, S. M. Liew, C. J. Ng, R. Hisham Shunmugam, and P. Glasziou, "Development of a Search Strategy for an Evidence Based Retrieval Service," (in eng), PloS one, vol. 11, no. 12, pp. e0167170-e0167170, 2016, doi: 10.1371/journal.pone.0167170.

. L. A. Kloda, J. T. Boruff, and A. S. Cavalcante, "A comparison of patient, intervention, comparison, outcome (PICO) to a new, alternative clinical question framework for search skills, search results, and self-efficacy: a randomized controlled trial," (in eng), J Med Libr Assoc, vol. 108, no. 2, pp. 185-194, 2020, doi: 10.5195/jmla.2020.739.

. C. Schardt, M. B. Adams, T. Owens, S. Keitz, and P. Fontelo, "Utilization of the PICO framework to improve searching PubMed for clinical questions," (in eng), BMC Med Inform Decis Mak, vol. 7, pp. 16-16, 2007, doi: 10.1186/1472-6947-7-16.

. L. Thabane, T. Thomas, C. Ye, and J. Paul, "Posing the research question: not so simple," Canadian Journal of Anesthesia/Journal canadien d'anesthésie, vol. 56, no. 1, p. 71, 2008/12/24 2008, doi: 10.1007/s12630-008-9007-4.

. A. Cooke, D. Smith, and A. Booth, "Beyond PICO: the SPIDER tool for qualitative evidence synthesis," Qual Health Res, vol. 22, no. 10, pp. 1435-43, Oct 2012, doi: 10.1177/1049732312452938.

. I. Korstjens and A. Moser, "Series: Practical guidance to qualitative research. Part 2: Context, research questions and designs," Eur J Gen Pract, vol. 23, no. 1, pp. 274-279, Dec 2017, doi: 10.1080/13814788.2017.1375090.

. A. Booth, "Clear and present questions: Formulating questions for evidence based practice," LIBRARY HI TECH, vol. 24, 07/01 2006, doi: 10.1108/07378830610692127.

. J. E. Bialosky, M. D. Bishop, and J. A. Cleland, "Individual expectation: an overlooked, but pertinent, factor in the treatment of individuals experiencing musculoskeletal pain," (in eng), Phys Ther, vol. 90, no. 9, pp. 1345-1355, 2010, doi: 10.2522/ptj.20090306.

. J. Barth, A. Kern, S. Lüthi, and C. M. Witt, "Assessment of patients’ expectations: development and validation of the Expectation for Treatment Scale (ETS)," BMJ Open, vol. 9, no. 6, p. e026712, 2019, doi: 10.1136/bmjopen-2018-026712.

. A. H. McGregor and S. P. Hughes, "The evaluation of the surgical management of nerve root compression in patients with low back pain: Part 2: patient expectations and satisfaction," (in eng), Spine (Phila Pa 1976), vol. 27, no. 13, pp. 1471-6; discussion 1476-7, Jul 1 2002, doi: 10.1097/00007632-200207010-00019.

. J. Boote, R. Newsome, M. Reddington, A. Cole, and M. Dimairo, "Physiotherapy for Patients with Sciatica Awaiting Lumbar Micro-discectomy Surgery: A Nested, Qualitative Study of Patients' Views and Experiences," Physiother Res Int, vol. 22, no. 3, Jul 2017, doi: 10.1002/pri.1665.

. E. R. Eaves et al., "A qualitative study of changes in expectations over time among patients with chronic low back pain seeking four CAM therapies," BMC Complement Altern Med, vol. 15, p. 12, Feb 5 2015, doi: 10.1186/s12906-015-0531-9.

. E. Laerum, A. Indahl, and J. S. Skouen, "What is "the good back-consultation"? A combined qualitative and quantitative study of chronic low back pain patients' interaction with and perceptions of consultations with specialists," J Rehabil Med, vol. 38, no. 4, pp. 255-62, Jul 2006, doi: 10.1080/16501970600613461.

. Y. Rehman et al., "Discrepancies Between Patient and Surgeon Expectations of Surgery for Sciatica: A Challenge for Informed Decision Making?," (in eng), Spine (Phila Pa 1976), vol. 44, no. 10, pp. 740-746, May 15 2019, doi: 10.1097/brs.0000000000002914.

. J. Williamson, C. Bulley, and F. Coutts, "What do patients feel they can do following lumbar microdiscectomy? A qualitative study," Disabil Rehabil, vol. 30, no. 18, pp. 1367-73, 2008, doi: 10.1080/09638280701639915.

. A. H. McGregor, C. J. Dore, and T. P. Morris, "An exploration of patients' expectation of and satisfaction with surgical outcome," Eur Spine J, vol. 22, no. 12, pp. 2836-44, Dec 2013, doi: 10.1007/s00586-013-2971-6.

. S. S. Myers et al., "Patient expectations as predictors of outcome in patients with acute low back pain," J Gen Intern Med, vol. 23, no. 2, pp. 148-53, Feb 2008, doi: 10.1007/s11606-007-0460-5.

. K. Rönnberg, B. Lind, B. Zoëga, K. Halldin, M. Gellerstedt, and H. Brisby, "Patients?? Satisfaction With Provided Care/Information and Expectations on Clinical Outcome After Lumbar Disc Herniation Surgery," Spine, vol. 32, pp. 256-61, 02/01 2007, doi: 10.1097/01.brs.0000251876.98496.52.

. A. Soroceanu, A. Ching, W. Abdu, and K. McGuire, "Relationship between preoperative expectations, satisfaction, and functional outcomes in patients undergoing lumbar and cervical spine surgery: a multicenter study," Spine (Phila Pa 1976), vol. 37, no. 2, pp. E103-8, Jan 15 2012, doi: 10.1097/BRS.0b013e3182245c1f.

. T. Toyone, T. Tanaka, D. Kato, R. Kaneyama, and M. Otsuka, "Patients' expectations and satisfaction in lumbar spine surgery," (in eng), Spine (Phila Pa 1976), vol. 30, no. 23, pp. 2689-94, Dec 1 2005, doi: 10.1097/01.brs.0000187876.14304.15.

. S. Weckbach, T. Kocak, H. Reichel, and F. Lattig, "A survey on patients' knowledge and expectations during informed consent for spinal surgery: can we improve the shared decision-making process?," Patient Saf Surg, vol. 10, p. 15, 2016, doi: 10.1186/s13037-016-0103-z.

. A. Yee, N. Adjei, J. Do, M. Ford, and J. Finkelstein, "Do patient expectations of spinal surgery relate to functional outcome?," Clin Orthop Relat Res, vol. 466, no. 5, pp. 1154-61, May 2008, doi: 10.1007/s11999-008-0194-7.

. J. P. Kross and A. Giust, "Elements of Research Questions in Relation to Qualitative Inquiry," The Qualitative Report, vol. 24, pp. 24-30, 2019.

. J. J. Riva, K. M. P. Malik, S. J. Burnie, A. R. Endicott, and J. W. Busse, "What is your research question? An introduction to the PICOT format for clinicians," (in eng), J Can Chiropr Assoc, vol. 56, no. 3, pp. 167-171, 2012. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/22997465 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430448/.

. J. W. Creswell, Educational research: Planning, conducting, and evaluating quantitative and qualitative research (3rd ed.). New Jersy: Upper Saddle River, N.J; Pearson/Merrill Prentice Hall, , 2008.

. K. Malterud, "Qualitative research: standards, challenges, and guidelines," The Lancet, vol. 358, no. 9280, pp. 483-488, 2001/08/11/ 2001, doi: https://doi.org/10.1016/S0140-6736(01)05627-6.

. K. Caldwell, L. Henshaw, and G. Taylor, "Developing a framework for critiquing health research: An early evaluation," Nurse Education Today, vol. 31, no. 8, pp. e1-e7, 2011/11/01/ 2011, doi: https://doi.org/10.1016/j.nedt.2010.11.025.

. P. Lee, "Understanding and critiquing qualitative research papers," (in eng), Nurs Times, vol. 102, no. 29, pp. 30-2, Jul 18-24 2006.

. J. S. Ash, D. F. Sittig, V. Seshadri, R. H. Dykstra, J. D. Carpenter, and P. Z. Stavri, "Adding insight: a qualitative cross-site study of physician order entry," (in eng), Int J Med Inform, vol. 74, no. 7-8, pp. 623-628, 2005, doi: 10.1016/j.ijmedinf.2005.05.005.

. M. J. Falco, "Human Inquiry: A Sourcebook of New Paradigm Research. Edited by Peter Reason and John Rowan. (New York: John Wiley & Sons, 1981. Pp. xxiv + 530. $72.00, cloth; $17.95, paper.)," American Political Science Review, vol. 77, no. 2, pp. 559-560, 1983, doi: 10.2307/1959048.

. M. A. Neergaard, F. Olesen, R. S. Andersen, and J. Sondergaard, "Qualitative description - the poor cousin of health research?," (in eng), BMC Med Res Methodol, vol. 9, p. 52, Jul 16 2009, doi: 10.1186/1471-2288-9-52.

. C. Bradshaw, S. Atkinson, and O. Doody, "Employing a Qualitative Description Approach in Health Care Research," (in eng), Glob Qual Nurs Res, vol. 4, pp. 2333393617742282-2333393617742282, 2017, doi: 10.1177/2333393617742282.

. P. Farrugia, B. A. Petrisor, F. Farrokhyar, and M. Bhandari, "Practical tips for surgical research: Research questions, hypotheses and objectives," (in eng), Can J Surg, vol. 53, no. 4, pp. 278-281, 2010. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/20646403

. S. Ratan, T. Anand, and J. Ratan, "Formulation of Research Question – Stepwise Approach," Journal of Indian Association of Pediatric Surgeons, vol. 24, p. 15, 01/01 2019, doi: 10.4103/jiaps.JIAPS_76_18.

. M. Aydin, "Exploring Pre-Service Science Teacher Methods and Strategies for The Driving Questions in Research Inquiry: From Consulting an Instructor to Group Discussion," The International Journal of Environmental and Science Education, vol. 11, pp. 559-570, 04/01 2016, doi: 10.12973/ijese.2016.404a.




How to Cite

Rehman, Y. (2021). Difference between Quantitative and Qualitative Research Question- PICO vs. SPIDER. American Scientific Research Journal for Engineering, Technology, and Sciences, 77(1), 188–199. Retrieved from https://asrjetsjournal.org/index.php/American_Scientific_Journal/article/view/6730