Evidence Based Practice
The Essential First Step in EBP
ASK is the essential first step of EBP.
Developing an answerable clinical research question can help to:
- Determine the essential elements of the question (Patient/Population/Problem, Intervention, Control, Outcome)
- Differentiate between background and foreground information needs; Identify gaps in knowledge
- Assist to develop synonyms for a comprehensive search
- Develop a structured search string
- Determine the domain of the question (therapy/treatment, prevention, diagnosis, prognosis, etiology, meaning)
Background vs. Foreground Questions
Are there elements of the question which require basic (background) research? Is there a gap in the clinician's/researcher's knowledge about specific elements of the question?
- What additional information does the clinician/researcher require to better understand the patient/population or problem?
- What additional information does the clinician/researcher require to better understand the intervention proposed?
- What additional information does the clinician/researcher require to better understand the control variable proposed?
- What additional information does the clinician/researcher require to better understand the desired outcome?
Background questions are typically answered with textbooks, reference texts, summary/review articles, and point-of-care tools.
Background question example:
Asian-American adult female with type 2 diabetes mellitus requests alternatives to insulin treatment.
- What is type 2 diabetes mellitus?
- Is type 2 diabetes mellitus prevalent in the Asian-American community?
- What is the standard of treatment for adult women with type 2 diabetes?
- What should be known about insulin treatments?
- What are the effects of untreated type 2 diabetes mellitus?
Foreground questions combine predetermined elements of the clinical problem to acquire specific knowledge. They are more complex and specific than background questions.
Foreground questions combine the Patient/Population/Problem and the Intervention and the Control treatment and the desired Outcome into a PICO format.
PICO Question Format
|P||Patient/Population/Problem||Demographics, Problem type, Diagnosis|
|I||Intervention/Exposure||Therapeutic, preventative, diagnostic, time, exposure|
|C||Comparison/Control||Placebo, standard of care, preventative measure, not applicable|
|O||Outcome measure||Mortality rate, measure of test, rate of disease progression, resolution|
When forming your questions using PICO, consider:
- Demographic variables can include: age, gender, ethnicity, socioeconomic status in addition to health issue.
- Comparison is not required
- Outcomes measure a positive impact on the patient/population's wellbeing and should be measurable. Use validated instruments and assessments when possible.
- Using the PICO format to develop a searchable & answerable question will provide the elements needed to obtain the best evidence from rigorous studies with statistically relevant findings.
This video and more EBP related videos can be found on Carrie Price's YouTube Channel
- Last Updated: Aug 7, 2023 12:46 PM
- URL: https://libraryguides.binghamton.edu/evidencebasedpractice
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