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Literature Searching: Asking a focused clinical question

Asking a well-designed question

“A prudent question is one-half of wisdom” (Francis Bacon)

Defining the search query is the first critical stage of literature search. All consequent stages will develop from the question’s parameters, so it is important that you clarify the question that needs answering.

A clear and focused question is more likely to lead to a credible and useful answer as it:

  • will help you focus on the clinical problem that is most important.
  • will help focus the literature search, by easily allowing the query to be broken down into its component parts.

but a poorly formulated question can lead to an uncertain answer and create confusion. A poorly constructed question may:

  • result in a search that is not clear in its objective. 
  • lead to the pursuit of irrelevant ideas. 
  • likely be too broad in its result to be useful
  • lead to too many irrelevant articles

Focusing the question

  1. Write down the patient scenario (or research idea) as a question or hypothesis.
  2. Define keywords and synonyms
  3. Set out the scope of the search query (e.g. inclusion and exclusion criteria, date range, etc).
  4. Use a framework to help structure the question and identify the concepts to search

PICO framework is particularly useful for clinical questions based on quantitative research
 

Using PICO

Framework item:

Think about:

Patient Problem (or Population)

How would I describe a group of patients similar to mine? Clinical traits but also think about the patient's demographics such as age, gender?  Or what is the problem type? Characterise your patient sufficiently to allow comparison with patients in the studies you find. WHO

Intervention

What type of intervention is being considered? For example is this a medication or some other form of treatment? Be specific. WHAT

Comparison or Control

Is there a comparison treatment to be considered? The comparison may be with another medication, another form of treatment, or no treatment at all. Again, be specific. Does not always apply.

Outcome

What are you trying to accomplish, measure, improve or affect. What would be the desired effect you would like to see? What effects are not wanted? Are there any side effects involved with this form of testing or treatment? Again, be specific.

 

PICO: Developing the Answerable Clinical Question

This lecture focuses on developing clinical questions and learning how the PICO format can aid our search for the best clinical evidence.

PICO: A Model for Evidence Based Research

How to use PICO, a model that outlines your clinical research question.