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Evidence-Based Practice: Ask a Question

Ask a Clinical Question

A good question will:

  • Define your information need
  • Identify key search concepts
  • Enable you to decide appropriate resources to search

Background questions: 

Address general queries about a disease, condition, test or treatment that can be answered sufficiently using medical textbooks or point-of-care tools. Use these resources to answer this type of question:UpToDate, Access Medicine ClinicalKey or ClinicalKey for Nursing

Foreground questions: 

Address aspects of care, therapy options or possible outcomes in relation to a specific patient or situation and require a more in-depth literature search to find the answer.  Foreground questions are best answered using the Finding the Evidence page of this guide.

Answering foreground questions involves developing well-formed, focused clinical questions. The PICO framework is commonly used to translate and structure patient dilemmas into focused questions. Using PICO helps to identify the important concepts for your search strategy and makes searching for evidence easier and more time effective.

Determining the type of clinical question will influence how you structure your PICO framework, the databases you use, and how you search them to find the most appropriate level of evidence. The most common types of clinical questions are:

  • Aetiology: the relationship between an exposure or causal factor and a patient developing a condition
  • Diagnosis: the validity and reliability of a diagnostic test or screening method
  • Therapy: the most beneficial treatment or prevention for a condition (intervention could be drug therapy, surgery, physical therapy, etc.)
  • Prevention: How to reduce the chance of disease through identification and modification of risk factors
  • Prognosis: the likely disease progression for patients with or without treatment

 

PICO

Use the PICO acronym to break down your question.

PICO is an acronym used to breakdown a clinical question or problem into appropriate keywords that enables effective searching within a database. Each letter of the acronym represents a different component of the clinical question.

Practice clinical questions are available at the EBM knowledge translation program

PICO Video tutorial

PICO Exercise