Librarian
Looking for background or foreground information?
Background questions ask for general knowledge about a condition or thing.
Foreground questions ask for specific knowledge to inform clinical decisions or actions.
Background Questions
- Asks for general knowledge about a disease or disease process
- Have two essential components:
- A question root (who, what, when, etc.) with a verb
- A disorder, test, treatment, or other aspect of healthcare
- Example: What causes migraines? or How often should women over the age of 40 have a mammogram?
The background question is usually asked because of the need for basic information. It is not normally asked because of a need to make a clinical decision about a specific patient.
Foreground questions
- Ask for specific knowledge about managing patients with a disease
- Have 3 or 4 essential components (see PICO below)
PICO(T)
Evidence-based practice uses the PICO(T) model for formulating a searchable question.
PICO(T) is a mnemonic used to describe the four elements of a good clinical foreground question:
P = Population/Problem
How would I describe the problem or a group of patients similar to mine?
I = Intervention
What main intervention, prognostic factor or exposure am I considering?
C = Comparison
Is there an alternative to compare with the intervention?
O = Outcome
What do I hope to accomplish, measure, improve or affect?
T = Timeframe
The timeframe for data collection or time to outcome. Timeframe is not always included in this model.
PICO examples
| Element of the clinical question |
Patient |
Intervention (or cause, prognosis) |
Comparison (optional) |
Outcome |
| Example | In patients with acute bronchitis, | do antibiotics | none | reduce sputum production, cough or days off? |
| Example | In children with ADHD | do pharmacological stimulants (i.e. Adderall, Foculin) | non-stimulant medications | produce reduced instances of impulsivity? |
| Example | Among family-members of patients undergoing diagnostic procedures | does standard care, | listening to tranquil music, or audiotaped comedy routines | make a difference in the reduction of reported anxiety? |
Different types of questions
Fill in the blanks with information from your clinical scenario:
THERAPY
In_______________, what is the effect of ________________on _______________ compared with _________________?
ETIOLOGY
Are ______________ who have _______________ at ______________ risk for/of ____________ compared with _____________ with/without ______________?
DIAGNOSIS OR DIAGNOSTIC TEST
Are (Is) ________________ more accurate in diagnosing _______________ compared with ____________?
PREVENTION
For ___________ does the use of _________________ reduce the future risk of ____________ compared with ______________?
PROGNOSIS
Does ____________ influence ______________ in patients who have _____________?
MEANING
How do _______________ diagnosed with _______________ perceive __________________?
Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.
Chat with Amanda
Subject Specialists: NURS and HERS
Amanda Pruka
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amanda.pruka@winona.edu
Aurora Jacobsen
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aurora.jacobsen@winona.edu
