ASK is the essential first step of EBP.
Developing an answerable clinical research question can help to:
Are there elements of the question which require basic (background) research? Is there a gap in the clinician's/researcher's knowledge about specific elements of the question?
Background question example:
Asian-American adult female with type 2 diabetes mellitus requests alternatives to insulin treatment.
Foreground questions combine predetermined elements of the clinical problem to acquire specific knowledge. They are more complex and specific than background questions.
Foreground questions combine the Patient/Population/Problem and the Intervention and the Control treatment and the desired Outcome into a PICO format.
|P||Patient/Population/Problem||Demographics, Problem type, Diagnosis|
|I||Intervention/Exposure||Therapeutic, preventative, diagnostic, time, exposure|
|C||Control/Comparison||Placebo, Standard of care, Preventative measure, Not applicable|
|O||Outcome Measure||Mortality rate, Measure of test, Rate of disease progression, Resolution|
When forming your questions using PICO, consider:
|Intervention||Control||Outcome Measure||Level of Evidence|
|Disease or condition||Therapeutic measures: Exercise, medication, surgical, life style change||Standard of care, additional intervention, placebo, no control||Measurable improvement in impairment/disease factors||Randomized Control Trial (RCT)|
|Prevention||Risk factors, Medical history||Preventative measures||Alternative preventative measures or no control||Measurable improvement in impairment/disease factors||RCT or Prospective study|
|Diagnosis||Specific disease or condition||Diagnostic test or procedure||Standard of care||Measurable results of test/procedure utility/sensitivity/odds ratio||RCT or Cohort Study|
|Prognosis||Duration & sensitivity of main prognostic factor or clinical problem||Typically time related||Typically not applicable||Mortality rates or rates of disease progression||Cohort Study and/or Case-Control Series|
|Etiology||Risk factors, health disorders, medical history||Strength/dose/duration of intervention or exposure (risk factor) of interest||Typically not applicable||Mortality rates or rates of disease progression||Cohort Study|
I. Determine Clinical Question Elements
|PICO Question Elements||Your PICO Elements|
The most important element of this component
e.g. Diagnosis/disease/condition, age group, gender
I: Intervention/Prognostic factor/Exposure/Treatment
C: Comparison (if applicable)
e.g. Placebo, standard protocol, no treatment, alternative options
O: Outcome (measurable)
e.g. Reduce mortality/morbidity, improved symptoms, accurate/timely diagnosis
|Your answerable & searchable clinical question:|
II. Match Question Domain with Study Type
Type of Study
|Refer to the Evidence Pyramid:||Meta-analyses & Systematic reviews will provide the best answers to clinical questions|
III. Search strategy development
|PICO||Primary PICO Elements/Search terms||Synonym(s)||MeSh term|