Asking the 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 InterventionComparisonOutcomes

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 InterventionComparisonOutcomes

Patient Or Problem InterventionComparisonOutcomes Patients who have suffered strokes

Patient Or Problem InterventionComparisonOutcomes Patients who have suffered strokes Stroke units

Patient Or Problem InterventionComparisonOutcomes Patients who have suffered strokes Stroke units Normal hospital care

Patient Or Problem InterventionComparisonOutcomes 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 InterventionComparisonOutcomes

Patient Or Problem InterventionComparisonOutcomes Acute Cough in primary care setting

Patient Or Problem InterventionComparisonOutcomes Acute Cough in primary care setting Antibiotics

Patient Or Problem InterventionComparisonOutcomes Acute Cough in primary care setting AntibioticsNo antibiotics

Patient Or Problem InterventionComparisonOutcomes Acute Cough in primary care setting AntibioticsNo antibiotics Duration and severity of illness

Or Do antibiotics shorten a acute cough in primary care?