Question development is an integral part of an effective search. On this page, you'll find information on the different types of questions you might ask, along with templates and tools for question formation.
A good question...
Focuses your information needs
Identifies key search concepts
Points you in the direction of potential resources
背景问题 Background Questions
These questions are general in nature and provide foundational information on a single concept. Background questions cover:
Terminology
General Pathology
Patient Education Resources
General Drug Information
Examination/Assessment Procedures
Examples
What is the pathology of asthma?
What drugs are used to treat hypertension?
How do I perform a psychological assessment?
What education resources exist for patients with gestational diabetes?
How is hepititis B diagnosed?
What does a normal heartbeat sound like?
前景问题 Foreground Questions
These questions bring together multiple concepts related to a specific clinical situation or research topic. They are typically divided into two categories:
Qualitative Questions aim to discover meaning or gain an understanding of a phenomena. They ask about an individual's or population's experience of certain situations or circumstances
Quantitative Questions aim to discover cause and effect relationships by comparing two or more individuals or groups based on differing outcomes associated with exposures or interventions.
These questions are best answered using the resources found in the 6S Pyramid page of this guide.
前景问题构建
Building an effective foreground question can be challenging.The following models will help:
定性问题（Qualitative Questions）: The PS Model
P - Patient/Population
S- Situation
How do/does ___[P]____ experience _____[S]_____?
Ex. How do caregiver-spouses of Alzheimer patients experience placing their spouse in a nursing home?
定量问题（Quantitative Questions）: The PICO(T) Model
A quantitative approach can answer many different types of questions, but all can be formatted by following the PICO(T) Model outlined below:
PICO涵义
Patient, Population or Problem
What are the characteristics of the patient or population?
What is the condition or disease you are interested in?
Intervention or exposure
What do you want to do with this patient (e.g. treat, diagnose, observe)?
Comparison
What is the alternative to the intervention (e.g. placebo, different drug, surgery)?
Outcome
What are the relevant outcomes (e.g. morbidity, death, complications)?
Examples
Example 1
Your next patient is a 72-year-old woman with osteoarthritis of the knees and moderate hypertension, accompanied by her daughter, a lab tech from the hospital. The daughter wants you to give her mother a prescription for one of the new COX-2 inhibitors. She has heard that they cause less GI bleeding. Her mother is concerned that the new drugs will mean more out of pocket costs each month.
| Patient/Problem | Intervention | Comparison Intervention | Outcome |
| 72 year old woman with osteoarthritis of the knee and moderate hypertension | COX-2 Inhibitor | other NSAIDS |
|
Specific Question：In a 72 year old woman with osteoarthritis of the knee, can COX-2 Inhibitor use decrease the risk of GI Bleeding compared with other NSAIDs?
Example 2
You have been treating a 54-year old woman for many years and despite the excellence of your fixed partial denture restorations, the intense routine maintenance by her periodontist, and good homecare, she has been experiencing a continued deterioration of her periodontal tissues. Her attempts to quit smoking have been unsuccessful; otherwise she is in good health and taking no medications. Because you are her primary care dentist, she has questioned you about her current dilemma. The periodontist has suggested a 3-week course of doxycycline therapy to control her latest exacerbation of periodontal disease, but she is concerned about Food and Drug Administration (FDA) reports asking for prudent use of antibiotics. How do you advise this patient?
| Patient/Problem | Intervention | Comparison Intervention | Outcome |
| 54 year old woman with exacerbation of periodontal disease | doxycyline | no treatment |
|
Specific Question：For a 54 year old woman with periodontal disease, how effective is the therapeutic use of doxcyline decrease gum bleeding and recession compared to no treatment?
PICO(T) 问题构建模板
Therapy
In ___[P]___, do/does ___[I]___ result in ___[O]____ when compared with ___[C]___ over ___[T]____?
E.g.) In nursing home residents with osteoporosis, do hip protectors result in fewer injuries from slips, trips, and fallswhen compared with standard osteoporosis drug therapy over the course of their stay?
Etiology
Are ___[P]___ with ___[I]___ over ____[T]____ more likely to ___[O]____ when compared with ___[C]___ ?
E.g.) Are female non-smokers with daily exposure to second-hand smoke over a period of ten years or greater more likely to develop breast cancer when compared with female non-smokers without daily exposure to second-hand smoke?
Diagnosis
Is/are ___[I]___ performed on ___[P]___ more effective than ___[C]___ over ___[T]____in ___[O]____?
E.g.) Are self-reporting interviews and parent reports performed on children aged 5-10 more effective than parent reports alone over a four-week consultation process in diagnosing depression?
Prevention
In ___[P]___, do/does ___[I]___ result in ___[O]____ when compared with ___[C]___ over ___[T]____?
E.g.) In emergency room visitors, do hand sanitizing stations result in fewer in-hospital infections when compared with no hand sanitizing stations over a year-long pilot period?
Prognosis
Do/does ___[I]___ performed on ___[P]___ lead to ___[O]___ over ___[T]____compared with ___[C]____?
E.g.) Do regular text message reminders performed on patients recently diagnosed with diabetes lead to a lower occurrence of forgotten insulin doses over the first six months of treatment compared with no reminders?
问题的种类
临床问题的类型和对应的研究类型是问题构建的好的两个重要要素，这有助于聚焦问题和选择最佳证据类型。不同种类临床问题对应的最佳研究设计类型如下表。
| 常见临床问题类型: | 研究类型（Type of study） |
| 诊断（Diagnosis） how to select and interpret diagnostic tests | 前瞻性与金标准双盲比较/横断面研究 prospective, blind comparison to a gold standard or cross-sectional |
| 治疗（Therapy） how to select treatments that do more good than harm and that are worth the efforts and costs of using them | randomized controlled trial (随机对照试验)> cohort study(队列研究） |
| 预后（Prognosis） how to estimate the patient’s likely clinical course over time (based on factors other than the intervention) and anticipate likely complications of disease | cohort study （队列研究）> case control （病例对照）> case series（病例系列） |
| 病因/危害（Harm/Etiology） how to identify causes for disease (including iatrogenic forms) | cohort （队列研究）> case control（病例对照） > case series（病例系列） |
