ask for general knowledge about an illness, disease, condition, process or thing. For example:
Consult textbooks or point-of-care tools, such as UpToDate to answer background questions.
ask for specific knowledge to inform clinical decisions, typically concerning a specific patient or population. These questions tend to be more specific and complex compared to background questions. Foreground questions may be further categorized into one of 4 major types: treatment/therapy, diagnosis, prognosis, or etiology/harm. For example,
Why should you use PICO to define the clinical question?
|Patient, Population or Problem||How would I describe a group of patients similar to mine?|
|Intervention||Which main intervention, exposure, or prognostic factor am I considering?|
|Comparison (if appropriate)||What is the main alternative to compare with the intervention?|
|Outcome||What can I hope to accomplish, measure, improve, affect?|
|Type of Question||How would I categorize this question (therapy, diagnosis, prognosis, etiology/harm)?|
|Type of Study||What would be the best study design in order to answer this question? (see Types of Studies tab)|
Case 1: A 55-year African American male with hypertension lives in a rural area about 2-hours from his medical doctor. The doctor is considering prescribing a telemonitoring device to track the patient's blood pressure and to assess his compliance with the medication regimen.
P: 55-year old African American male with hypertension
C: usual care
O: compliance with medication regimen
Study question: Among middle-aged adult African American males on medication for hypertension, is telemonitoring an effective approach for ensuring compliance with a medication regimen?
Case 2: A 12-year old girl presents for her annual dental check up. She has three new cavities and you are trying to decide whether to prescribe a home-based fluoride regimen or recommend fluoride treatments at the dentist to prevent future caries.
P: 12-year old girl
I: home-based fluoride treatment
C: fluoride treatments at provider
O: prevention of dental caries
Study Question: Among adolescent girls, how does a home-based fluoride regimen compare with fluoride treatments at the dentist to prevent cavities?
Case 3: A 70-year old female has made multiple attempts to quit smoking in the past using nicotine replacement therapy. She presents at your practice with renewed motivation. You remember reading that anti-depressants can help people quit tobacco and would like evidence about this potential treatment in older women.
P: 70-year old female smoker
I: Anti-depressant, e.g. Buproprion, in combination with nicotine replacement therapy
C: nicotine replacement therapy alone
O: tobacco cessation