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Evidence-based research and practice / Asking and answering clinical questions |
The 49 Clinical Questions series: Experts and practitioners ask a series of structured questions based on clinical scenarios.
Clinical questions can fall into two categories; (1) background questions, and (2) foreground questions. To examine how these questions can arise, let's consider the following patient encounter:
Clinical Scenario | |
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Treatment plan: corrective lenses and schedule a follow-up at which point you may prescribe an eyepatch. You now have some additional questions that you would like answered by the evidence, prior to the follow-up appointment. These clinical questions are background and foreground questions. |
Background questions help us improve our understanding of a topic. These types of questions ask for general knowledge about a condition or a thing.
Examples:
Foreground questions "ask for specific knowledge to inform clinical decisions or actions."2
These questions are usually more complex as they contain several concepts such as a specific population, intervention, comparison and outcome. The organization of these concepts in a clinical questions, is referred to as PICO. For example:
P | Population | Pediatric patient presenting with amblyopia |
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I | Intervention | Eye-patch |
C | Comparison | Glasses |
O | Outcome | Improvement of condition |
Example of a PICO-structured foreground question:
Is an eyepatch recommended for the treatment of a child with amblyopia who is already being treated with glasses?
Formulating complex PICO questions takes practice. If you need help, please contact the Optometry and Vision Science Librarian.