Is the Question Right? Will the answer help me? Will the answer help the patient? Will the answer help the community at
large Is the question amenable to an
answer? Is it defined tightly enough
Remember the adage about tests – Will the result affect patient
management?
The same is true of EBM questions – Will the answer affect my patients
management
Questions Have Parts By critically analysing a question one
can ensure we are asking the right question
By breaking the question into its parts one creates a ready made search strategy
Question Components The patient or problem
The intervention
Comparison – with what etc
Outcome – one is concerned about
Example 1A TV programme has highlighted a
hospital in Suffolk in which a stroke unit has been set up that specialises in the treatment of patients who have suffered strokes. The hospital trust wants to know about the effectiveness of stroke units in terms of lives saved before deciding whether to invest in one.
Patient
Or Problem
Intervention Comparison Outcomes
Patients who have suffered strokes
Stroke units
Normal hospital care
Patient
Or Problem
Intervention Comparison Outcomes
Patients who have suffered strokes
Stroke units
Normal hospital care
Lives saved
Example 2
A acute cough is a common reason for patients to consult their GP. The causes of acute cough varies a lot. In GP the treatment often includes antibiotics. The effectiveness of Abx is questionable and there has been a great deal of concern about bacterial resistance from over-prescribing.
Patient
Or Problem
Intervention Comparison Outcomes
Acute Cough in primary care setting
Antibiotics No antibiotics
Patient
Or Problem
Intervention Comparison Outcomes
Acute Cough in primary care setting
Antibiotics No antibiotics
Duration and severity of illness