What is a Clinical Question?
- Melnyk and Finehout-Overholt (2015, pp 12.) states a well-designed clinical question in the PICOT format leads to a search that is efficient and finds the most relevant evidence.
- McMaster University has a good LibGuide
- It describes how to build a clinical question, how to clarify what type of question you have , and has templates to handle different types of clinical problems.
What is Background Information?
- Background information answers a general questions about a clinical topic.
- Examples of Background Information.:
- What is that disorder?
- What are the adverse effects of that drug?
- What are common skin complications of that treatment?
- Background resources give general overviews of the topic.
- Backgroundresources ncrease knowledge on a topic (and not necessarily on an issue with your patient).
- Background information is meant to increase your knowledge on a particular topic.
- Two people looking for background information on the same topic might come up with different citations, because they've had different clinical experiences.
- Background questions can be answered by using resources
- Textbooks (both in print and electronic),
- Narrative reviews in journals,
- Reputable drug apps.
These questions bring together multiple concepts related to a specific clinical situation or research topic. They are typically divided into two categories:
- Qualitative Questions aim to discover meaning or gain an understanding of a phenomena. They ask about an individual's or population's experience of certain situations or circumstances
- Quantitative Questions aim to discover cause and effect relationships by comparing two or more individuals or groups based on differing outcomes associated with exposures or interventions.
Evidence-Based Medicine's Levels of Evidence Pyramid version 6s
This website examines the evidence pyramid in terms of finding appropriate foreground information.
The 6S pyramid from McMaster University has provided a conceptual framework for searching information resources for evidence-based healthcare (EBHC) and is used in medical education and clinical informatics applications. There are links ot various databases and reference collections.
Alert: If a link on any one of these pages leads you to another university’s blocked library site, don't despair!
Look for access to that named link on our own DMC Library Information Resources. Libraries generally have to pay for subscriptions and so restrict their access.
DMC Library has many of these same subscriptions
Foreground questions are best answered by evidence found at different levels of the 6S Pyramid.
Dartmouth and Yale' s Evidence-Based Medicine (EBM) Pyramid with Explanation
This is a dynamic easy-to-use Evidence Pyramid with clear explanations of each level
This version was prepared by the University of Pittsburgh Health Science Library System
Alert: If a link on any one of these pages leads you to another university’s blocked library site, don't despair!
Look for access to that named link on our own DMC Library Information Resources. Libraries generally have to pay for subscriptions and so restrict their access.
DMC Library has many of these same subscriptions
Melnyck’s and Fineout-Overholt's PICO formulation with descriptors and examples
What is a PICOT Question? (From the George Gwinnett College Library)
Rating System for the Hierarchy of Evidence to Guide Clinical Interventions.
Once you have completed your literature search to find the best evidence to answer your clinical problem, this framework is one version used to help you evaluate the strength of the presented evidence.
|
Level |
Explanation |
|
I |
Evidence from a systematic review or meta-analysis of all relevant randomized controlled trials (RCTs) |
|
II |
Evidence obtained from well-designed RCTs |
|
III |
Evidence obtained from well-designed controlled trials without randomization |
|
IV |
Evidence from well-designed case-control and cohort studies |
|
V |
Evidence from systematic reviews of descriptive and qualitative studies |
|
VI |
Evidence from single descriptive or qualitative studies |
|
VII |
Evidence from the opinion of authorities and/or reports of expert committees |
Source: Modified from Elwyn et al. (2015) and Harris et al. (2001) :From Improving healthcare quality, patient outcomes, and costs with evidence-based practice
Elwyn, G., Quinlan, C., Mulley, A., Agoritsas, T., Vandik, P. O., & Guyatt, G. (2015): Trustworthy guidelines—excellent; customized care tools—even better. BioMed Central Medicine, 13(1), 199. Modified from Guyatt, G., & Rennie, D. (2002), Users’ guides to the medical literature. Chicago, IL: American Medical Association.