Formulate an answerable question

Descriptation:

A well known saying is that ‘the beginning of all wisdom lies not in the answer, but in the question’. The first step in evidence-based practice is to formulate a specific question. The question you have concerning your practice should be formulated so it is possible to find a scientific answer to the question. Posing specific questions relevant to a patient’s problem provides a focus to thinking, and it helps in the formulation of search strategies and in the process of critical appraisal of evidence.

Types Of question:

Background Questions:

  Background Questions Asked for general knowledge about a disorder
Has two essentials components:

• .Question root ( who, what, where, how, why)
• .Disorder
  
• Textbooks answer background questions.
• Not all topics are covered, easy to use, relatively inexpensive and can be opinion-based rather than evidence-based, written by experts in their fields.

Foreground Question

DescriptAsked for specific knowledge about managing patients with a disorder
It has 4 components (PICO analysis)

P - Patient/problem
I – Intervention
C - Comparison or control
O - Outcome

PICO:

Before we begin the hunt for evidence that relates to our clinical questions,we need to spend some time making the questions specific.Structuring and refining the question makes it easier to find an answer.One way to do this is to break the problem into parts.

we break question in 4 parts:

• Patient group
• Intervention (cause, diagnostic test, treatment etc0
• Comparison intervention
• Outcome

Patient or Problem:

This involves identifying those characteristics of the patient or problem that are most likely to influence the effects of the intervention. If you specify the patient or problem in a very detailed way you will probably not get an answer, because the evidence is usually not capable of providing very specific answers.So a compromise has to be reached between specifying enough detail to get a relevant answer, but not too
much detail to preclude getting any answer at all.

Intervention :

    it include the intervention that we are interested in and what we want to compare the effect of that intervention to.

Type of treatment (drug, procedure, therapy)
Intervention level (dosage, frequency)
Stage of intervention (preventative, early, advanced)
Delivery (who delivers the intervention? where?)

Comparison intervention:

compare the effect of an intervention to no intervention, or to another active Alternative interventions (standard treatment, placebo, another intervention)
There may not always be a comparison

Outcome:

The outcome or effects you are interested in, for example Improvement of symptoms, smoking side effects Improved quality of life Cost effectiveness and benefits for the service provider.

Examples:

1:“In patients with suspected pulmonary fibrosis, how does high-resolution CT compare with lung biopsy for establishing the diagnosis?”
P = Pulmonary fibrosis
I = High-resolution CT
C = Lung biopsy
O = Sensitivity/specificity

2:Do obstetrical complications during pregnancy increase the likelihood of schizophrenia in the child
P = Pregnant Female
I = Obstetrical complications
C = No obstetrical complications
O = Child hood

3:‘In patients with recurrent furunculosis, do prophylactic antibiotics, compared to no treatment, reduce the recurrence rate?’

P = patients with recurrent furunculosis
I  = prophylactic antibiotics
C  = no treatment
O  = reduction in recurrence rate of furunculosis

 Recent Related Research (from Pubmed) 


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