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Asking the questions Easy ?
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Triggers Individual patients Group initiatives Topical issues
National initiatives
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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
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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
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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
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Question Components The patient or problem The intervention
Comparison – with what etc Outcome – one is concerned about
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Analysis Grid Patient Or Problem Intervention Comparison Outcomes
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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.
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Patient Or Problem Intervention Comparison Outcomes
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Patients who have suffered strokes
Or Problem Intervention Comparison Outcomes Patients who have suffered strokes
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Patients who have suffered strokes Stroke units
Or Problem Intervention Comparison Outcomes Patients who have suffered strokes Stroke units
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Patients who have suffered strokes Stroke units Normal hospital care
Or Problem Intervention Comparison Outcomes Patients who have suffered strokes Stroke units Normal hospital care
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Patients who have suffered strokes Stroke units Normal hospital care
Or Problem Intervention Comparison Outcomes Patients who have suffered strokes Stroke units Normal hospital care Lives saved
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Or Do stroke units save lives ?
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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.
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Patient Or Problem Intervention Comparison Outcomes
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Acute Cough in primary care setting
Patient Or Problem Intervention Comparison Outcomes Acute Cough in primary care setting
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Acute Cough in primary care setting Antibiotics
Patient Or Problem Intervention Comparison Outcomes Acute Cough in primary care setting Antibiotics
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Acute Cough in primary care setting Antibiotics No antibiotics
Patient Or Problem Intervention Comparison Outcomes Acute Cough in primary care setting Antibiotics No antibiotics
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Acute Cough in primary care setting Antibiotics No antibiotics
Patient Or Problem Intervention Comparison Outcomes Acute Cough in primary care setting Antibiotics No antibiotics Duration and severity of illness
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Or Do antibiotics shorten a acute cough in primary care?
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