Clinical questions arise from encounters with patients or problem in the clinical setting. While some clinical questions can be easily answered by consulting a reference guide, some questions are more complex and require you to search for research evidence.
Clarifying the key elements of the clinical question is an important step to frame the question and locate an answer to inform clinical decisions. To build a well-defined clinical question, you'll need to consider the type of foreground question and the most appropriate type of study or methodology that can address the question. It is important to look for the study design that will yield the highest level of evidence in the evidence pyramid.
Background questions:
Foreground questions:
The PICO is a mnemonic that captures the key elements to help develop focused clinical questions. It can also be used to formulate the search strategy by identifying key concepts.
For examples of well-defined PICO questions, visit the Cochrane Clinical Answers. The Cochrane Clinical Answers provides evidence-based answers to PICO clinical questions that come across in clinical practice. These answers have been created to inform decision-making at the point of care, and link to Cochrane Reviews that have been filtered to its clinically relevant aspects.
To develop a clinical question, it is important to think about the type of question you have. Here are some common types of clinical questions:
Different clinical questions are best answered by different types of research studies. The best available or highest level of evidence to answer your question may not always be available in a systematic review or meta-analysis.
Question | Study |
All clinical questions | systematic review, meta-analysis |
Therapy | RCT |
Prognosis | cohort study, case control, case series |
Diagnosis | prospective, blind comparison to a gold standard or cross-sectional |
Etiology/Harm | RCT, cohort study, case control, case series |
Prevention | RCT, cohort study, case control, case series |
Cost | economic analysis |
Point of care tools are designed for rapid consultation and provide high level summaries of current evidence for diagnosis, tests, and interventions.
Drug information resources provide answers for drug information question, drug identifier tools, drug interaction tools, drug calculators, and more.
Differential diagnosis tools are used to help with diagnosis decision making by differentiating between diseases and conditions that present similar clinical features.
Clinical practice guidelines are systematically developed statements that provide recommendations and guide decisions about diagnosis, management, and treatment for specific areas of healthcare.