The well-built clinical question: a key to evidence-based decisions Richardson, WS. Types of Questions Primary Question Types Therapy: how to select treatments to offer our patients that do more good than harm and that are worth the efforts and costs of using them. Diagnostic tests : how to select and interpret diagnostic tests, in order to confirm or exclude a diagnosis, based on considering their precision, accuracy, acceptability, expense, safety, etc.
Other Question Types Clinical findings: how to properly gather and interpret findings from the history and physical examination. Clinical manifestations of disease: knowing how often and when a disease causes its clinical manifestations and how to use this knowledge in classifying our patients' illnesses. Prevention: how to reduce the chance of disease by identifying and modifying risk factors and how to diagnose disease early by screening. Subjects: Clinicians , Nursing , Students.
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If you continue with this browser, you may see unexpected results. Evidence Based Medicine This guide is designed to assist health care professionals and students become effective and efficient users of the medical literature. Please take a short survey to help improve this guide and to better serve guide users. Take the Survey.
The P. I I ntervention, Prognostic Factor, or Exposure Which main intervention, prognostic factor, or exposure am I considering? C C omparison or Intervention if appropriate What is the main alternative to compare with the intervention? O O utcome you would like to measure or achieve What can I hope to accomplish, measure, improve, or affect? National Center for Biotechnology Information , U.
Evid Based Spine Care J. Annie L. Raich 1 and Andrea C. Skelly 1. Raich 1 Spectrum Research, Inc. Andrea C.
Skelly 1 Spectrum Research, Inc. Author information Copyright and License information Disclaimer. Address for correspondence Andrea C. Skelly Spectrum Research, Inc. This article has been cited by other articles in PMC. Introduction The most important step in conducting a high-quality research study is to create a study question that will provide the guidance for the planning, analysis, and reporting of your study. What Is a Study Question? The Process of Creating an Effective Study Question Step 1: Draft a Preliminary Study Question The first step is to draft a simple clinical question you would like to answer or a hypothesis you would like to explore.
Table 1 Improving study question focus. Study question too broad Study question somewhat more answerable Study question with improved focus What is the comparative effectiveness of laminoplasty versus laminectomy and fusion? What is the comparative effectiveness of laminoplasty versus laminectomy and fusion for adults with cervical myelopathy? What is the comparative effectiveness of laminoplasty versus laminectomy and fusion for adults with myelopathy due to spondylosis in the cervical spine?
Open in a separate window. While the more focused study question above is an improvement, there are some additional questions you should ask: What types of patients and pathologies do you want to study or exclude from the study?
Consider the following issues when creating your PICO table: Patients : Consider factors related to the condition, demographics e. Inclusion Exclusion Patients What patient group do you want to include?
Symptomatic adults with cervical myelopathy due to spondylosis Patients under 18 years of age Ossification of the posterior longitudinal ligament OPLL Tumor Trauma Infection Deformity Intervention What surgical treatment, procedure, or implants are you interested in?
Cervical laminoplasty Comparison What is the comparison treatment? Cervical laminectomy and fusion Outcomes What outcomes are you interested in e. Step 5: Consider Additional Questions By this point, you should have not only a solid study question, but at least a preliminary idea of how you might approach answering it, and there are some additional questions to consider for another round of refinement.
To be more specific in your study focus, consider these additional questions: What might constitute a clinically meaningful improvement? Is there a specific hypothesis that you would like to test? Table 3 Final study question.
In symptomatic adults with cervical myelopathy due to spondylosis, does laminoplasty improve the severity of myelopathy as measured by the JOA recovery rate compared with laminectomy and fusion at 12 months?
Conclusions Great study ideas take time to formulate. Funding This article was funded by AOSpine. References 1. Philadelphia: Lippincott Williams and Wilkins; Conceiving the research question; pp.
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