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 Intervention Comparison Outcomes

Or
Problem
 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 Intervention Comparison Outcomes
Or
Problem
Patient Intervention Comparison Outcomes
Or
Problem

Patients
who
have
suffered
strokes
Patient Intervention Comparison Outcomes
Or
Problem

Patients Stroke
who units
have
suffered
strokes
Patient Intervention Comparison Outcomes
Or
Problem

Patients Stroke Normal

who units hospital
have care
suffered
strokes
Patient Intervention Comparison Outcomes
Or
Problem

Patients Stroke Normal Lives

who units hospital saved
have care
suffered
strokes
 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 Intervention Comparison Outcomes
Or
Problem
Patient Intervention Comparison Outcomes
Or
Problem

Acute
Cough in
primary
care
setting
Patient Intervention Comparison Outcomes
Or
Problem

Acute Antibiotics
Cough in
primary
care
setting
Patient Intervention Comparison Outcomes
Or
Problem

Acute Antibiotics No
Cough in antibiotics
primary
care
setting
Patient Intervention Comparison Outcomes
Or
Problem

Acute Antibiotics No Duration

Cough in antibiotics and
primary severity of
care illness
setting
 Or

Do antibiotics shorten a acute

cough in primary care?