The SPICE question format may be another useful alternative for clinical question formulation. An example of a SPICE research question might be:
In urban inpatient hospitals (S) with underserved patients (P), do patient assistance programs (I) as opposed to standard care without patient assistance program support (C) impact the quality of care and health outcomes (E)?
SPICE is another popular format for clinical question creation in Evidence-Based Practice research. The SPICE question format was created and intended to build on the PICO format by breaking down the population to two features: the setting or location and the perspective or nature of the population. This slightly broader definition of population is intentional to encourage researchers to consider early in their question formulation ways in which the settings may impact perspectives or vice versa.
The other unique feature of SPICE that can make it useful in evaluation and quality improvement research is that this question format can lead to a better understanding of impact. Outcome measures and other notable changes after an intervention or exposure could be easier to articulate when researchers utilize this format.
