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Evidence-Based Practice: Ask

This guide will help you work through the process of Evidence-Based Practice.

Ask

At this step of the process, you are formulating the question based on the patient situation or research topic. REMEMBER: Your problem will guide your question and whether you will use PICOT or other tools to help you formulate your question. If your topic leads to a Qualitative question, see the Qualitative Research guide to help you form your question.

Additionally, identifying whether your topic is a background or foreground question will inform where you will search and what type of research methods you should look for and use.

Is my topic question a background or foreground or qualitative question?

A background question addresses a knowledge gap. It is asked by those who are relatively inexperienced with a topic or when they encounter a problem for the first time (Booth, 2006). It may be asking basic information about a topic of interest.

For Example:

"What is neuropathic pain in patients with diabetes?"

"How does acetominophen work in the body?"

"What is capsacin?"

A foreground question addresses clinical decision-making. The clinician asks a foreground question when there are two or more competing options and must make a clinical decision. The level of prior knowledge with the topic must be greater to be able to pose this type of question. (Booth, 2006)

It asks for specific knowledge to inform clinical decisions or actions, and must take into consideration the patient and the desired clinical outcome. (Weinfeld & Finkelstein, 2005)

For Example:

"Will acetaminophen or capsacin cream control neuropathic pain in a patient with diabetes?"

You will use "PICO" (see below) to help you create an answerable clinical question that will inform your search.

A qualitative question is asking why and how. It is looking for meaning and perspectives of the population of interest. See the definition of Qualitative Research to find out more about qualitative questions.

For Example:

How do patients having neuropathic pain experience the pain management experience from attending pain management clinics?

Why do families choose palliative care for their dying relative?

 

PICOT for Foreground Questions

Identify who...

Who is the patient?

What is their concern?

What is their problem?

This will identify the patient or population of interest for your research topic.

For Example:

Patients with diabetes and neuropathic pain.

Identify what...

What do you want to study about in the population you have identified?

What has the patient been prescribed?

What has the patient been told to do?

What treatment is the patient given?

Assorted Pills

This will identify what intervention are you interested in for the population?

For Example:

Acetaminophen

Identify another what (if needed)...

What alternatives do you want to know about or the patient want to know about?

The comparison is not a required element. If there is no comparator, this will be a simple "PIO".

This will help you identify (if necessary) an alternative intervention.

For Example:

Capsacin cream

Identify specific outcomes...

What are the patient's or population's desired outcomes?

What problem do they want solved?

Pain Scale

 

This will help you identify the specific outcomes that you need to look for in the research.

For Example:

Control of neuropathic pain

Identify any time limits (if needed)...

Is there a time span that needs to be considered?

Is there a duration of action that needs to be considered?

Clock

This may not be needed.

For Example:

Over a lifetime with neuropathic pain.

A year after diagnosis of neuropathic pain.

 

Formulate the clincial question using variations of the format: 

In "P", is "I" or "C" "O" over T

This question is the check you will use when you are searching for the evidence.

Does the evidence source (literature, reports, posters, etc.) answer the clinical question?

Book Computer

For Example:

In patients with diabetes and neuropathic pain, is acetaminophen or capsacin cream effective at controling neuropathic pain over a year after diagnosis?

Other Tutorials on ASK

More tutorials on PICO and the clinical question.