Evidence-based Medicine: Asking The Answerable Question (Question Templates as Tools)
2003; American Academy of Pediatrics; Volume: 24; Issue: 8 Linguagem: Inglês
10.1542/pir.24-8-265
ISSN1529-7233
AutoresGary M. Onady, Marc A. Raslich,
Tópico(s)Nursing Diagnosis and Documentation
Resumo1. Gary M. Onady, MD, PhD* 2. Marc A. Raslich, MD* 1. *Medicine-Pediatrics Program, Wright State University, Dayton, OH We introduce the evidence-based medicine (EBM) approach by distilling the process of asking an answerable question to a few easy steps. (1) A promise made in our introduction to this series involved reviewing techniques whereby literature searches can be conducted more efficiently through the use of convenient tools. (2) Asking answerable clinical questions is the first of five steps in the EBM process that will deliver on this promise. The wisdom recently discovered in a Chinese fortune cookie presents an essential and relevant truth: “It is harder to ask the right questions than to find answers for the wrong questions.” [Chinese Fortune Cookie (The Orient Express, Dayton, OH, 2002)]. Why is an EBM approach to formalizing a clinical question necessary? Asking questions helps to identify and satisfy our own learning needs, aids in communicating with our colleagues, and allows us to teach others by modeling sound EBM techniques. Improvement is needed in this particular skill. In a study examining “curbside consultations,” clinical questions were more likely to be answered directly and less likely to require a formal consultation when the question defined clearly both a proposed intervention and a relevant outcome. (3) However, only about 40% of questions asked of consultants contained these two components. In addition, a well-developed question can be used as a tool that enables the physician to focus a search by using terms embedded within the question. A search stemming from a poorly formulated question often is not clear in its objectives, leads to pursuit of irrelevant ideas, reveals vague conclusions, and is likely to be too expansive in its results to be useful clinically. (4) The EBM toolbox (Figure) illustrates the tools available for crafting the answerable question. The concept of using background or foreground questions as tools to launch a relevant literature …
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