Asking questions

In practice it is a rare day when you are not faced with a need to know some new information about the prognosis, treatment or management of a condition. Turning these clinical problems into a well-built ( answerable) clinical question is a key skill of evidence-based practice.

A prudent question is one half of wisdom
Francis Bacon (1561 -1626)

There are essentially two types of question:

Background questions

These ask for general knowledge about a disorder and have two main components.

  • A question root (who, what, how, when or why)
  • A disorder or specific aspect of a disorder (e.g. What causes dental caries? or What are the complications of root canal treatment?)

Foreground questions

These ask for specific knowledge about how to manage patients with a disorder and a good or well-constructed foreground question usually has four main elements:

  • P – The type of patient or the problem of interest
  • I – The main intervention or exposure E; this is commonly a treatment but it could be a diagnostic test, some prognostic factor etc.
  • C – The comparison intervention/s when relevant
  • O – The clinical outcome of interest.
  • Commonly referred to as PICO or PECO format.
  • e.g. In patients with tooth discolouration would home bleaching compared to placebo lead to whiter teeth?