Framing the Research Question
Evidence-based models use a process for framing a question,
locating, assessing, evaluating, and repeating as needed:
1. Framing the question: write out your information need in the form of a question.
Research questions can be thought of as:
Background questions: general knowledge about a disorder* or topic.
Foreground questions: specific knowledge about a patient or problem.
When constructing a research question, the PICO format is widely used for questions of therapy.
Frame your question to include:
|
|
Example: |
| P (patient/problem) | hospital infection |
| I (intervention/indicator) | handwashing |
| C (comparison) | no handwashing; other solution; masks |
| O (outcome of interest) | reduced infection |
Link to clinical question PICO worksheet (Dartmouth Biomedical Libraries)
- Link to worksheet for constructing PICO question online (Duke University Medical Center)
2. Finding sources of information: link to
3. Plan a search strategy
by identifying the major elements of your question, and translate
natural language terms to subject descriptors, MeSH terms, or
descriptors. Think about synonyms. Use the metadata to link to related
resources. Filter results using categorical limits for publication type, age group, year, and other limits.
4. Evaluate: critically appraise retrieved information.
*Sackett, D. L., Straus, S. E., Richardson, W.
S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM (2nd ed.).
Edinburgh ; New York: Edinburgh ; New York : Churchill Livingstone. page 15
http://tinyurl.com/nyuframing
Search Strategies--Background Information
Often at the beginning of a project, you will be looking for
overview/background information and you will need to answer a BACKGROUND QUESTION* with general knowledge about a disorder or
topic.
Background information may be found in sources such as:
·
reference book entries
·
textbooks, chapters, appendices
·
drug monographs, guides to diagnostic tests
·
the library’s Bobcat catalog
· selected electronic Reference Tools for Background information in the health sciences
Sample Search Strategies for Background Questions:
|
Question |
Appropriate source type: |
Sample Strategy(ies): |
|
What are the side effects of Lipitor? |
Drug reference book |
From the evidence pyramid, click on Background Information. One of the choices listed is:
|
|
I need an overview of gestational diabetes. |
Textbook |
From the evidence pyramid, click on Background Information. One of the choices listed is:
Search on name of disease or condition.
Use the Bobcat library catalog to search on gestational diabetes and retrieve: Title: Management of high-risk pregnancy : an evidence-based approach/ Queenan, John T., 2007. |
|
I am interested in the phenomenon of burnout in nurses. |
Textbook, monograph, review article |
|
|
What research is available on the issue of privacy related to computerized patient records? |
A Review article in a journal |
(A “Review” article in a journal may provide an up-to-date summary/overview of a broad topic. (Journal articles are discussed in more detail in foreground questions) · A Pubmed search: privacy computerized patient records Limited to publication type: “Review article” retrieves 62 citations. Here is one example: Agrawal R, Johnson C. Securing electronic health records without impeding the flow of information. Int J Med Inform. 2007 May-Jun;76(5-6):471-9. Epub 2007 Jan 3. Review. PubMed PMID: 17204451. |
|
What are the personal experiences of medical students? |
Memoir, biography, diary |
A BobCat search medical students biography (as query words anywhere in the record) leads to titles with subject headings to explore for related results:
Students, Medical
Personal Narratives |
*Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM (2nd ed.). Edinburgh ; New York: Edinburgh ; New York : Churchill Livingstone.
Search Strategies--Foreground Information
Foreground questions ask for specific knowledge about a Patient or problem, an Intervention, Comparison, and Outcome (commonly referred to as PICO).* Examples below are in PICO format.
Sample Search Strategies for Foreground Questions:
|
Question |
Natural language terms |
Terms translated to Subject headings/MeSH terms/Descriptors [Database] |
|
|
|
|
|
What is the effectiveness of CPM therapy following knee replacement in achieving optimal range of motion? |
CPM therapy Knee replacement |
arthroplasty, replacement, knee [MeSH] AND motion therapy, continuous passive [MeSH]
|
|
What is the effectiveness of restraints in reducing the occurrence of falls in patients 65 and over?
|
Falls Restraints |
Accidental falls [MeSH, CINAHL] AND Restraint, physical [MeSH, CINAHL] |
|
Does hand washing among healthcare workers reduce hospital acquired infections? |
Hand washing Hospital acquired infection |
Handwashing [MeSH] AND Cross infection [MeSH] |
*Heneghan, C., & Badenoch, D. (2002). Evidence-based medicine toolkit. London: BMJ Books.
Filtering the Literature for Best Evidence
Once you have done some initial database searching, you will want to think about "filtering" your results to locate the best evidence.
The handout attached below demonstrates filtering strategies in the most commonly used health sciences databases.
Sample Search Strategies
Description
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