Asking the right
questions
Easy ?
Triggers
Individual patients
 Group initiatives
 Topical issues
 National initiatives

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
Analysis Grid
Patient
Or
Problem
Intervention Comparison Outcomes
Example 1
A 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
Patient
Or
Problem
Patients
who
have
suffered
strokes
Intervention Comparison Outcomes
Patient
Or
Problem
Intervention Comparison Outcomes
Patients
who
have
suffered
strokes
Stroke
units
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
Or
Do stroke units save lives ?
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
Patient
Or
Problem
Acute
Cough in
primary
care
setting
Intervention Comparison Outcomes
Patient
Or
Problem
Intervention Comparison Outcomes
Acute
Antibiotics
Cough in
primary
care
setting
Patient
Or
Problem
Intervention Comparison Outcomes
Acute
Antibiotics
Cough in
primary
care
setting
No
antibiotics
Patient
Or
Problem
Intervention Comparison Outcomes
Acute
Antibiotics
Cough in
primary
care
setting
No
antibiotics
Duration
and
severity of
illness
Or
Do antibiotics shorten a acute
cough in primary care?