Health, Exercise, and Rehabilitative Sciences (HERS)


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Amanda Pruka
Krueger Library 126

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)


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  


Intervention (or cause, prognosis)

Comparison (optional)


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:

In_______________, what is the effect of ________________on _______________ compared with _________________?

Are ______________ who have _______________ at ______________ risk for/of ____________ compared with _____________ with/without ______________?

Are (Is) ________________ more accurate in diagnosing _______________ compared with ____________?

For ___________ does the use of _________________ reduce the future risk of ____________ compared with ______________?

Does ____________ influence ______________ in patients who have _____________? 

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.

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Subject Specialists: NURS and HERS

Amanda Pruka


Aurora Jacobsen