Types of Research Questions
Background vs Foreground Questions
In order to locate the most useful research, social workers must ask well-defined questions:
Background questions – the “forest” (broad in scope)
- seek general knowledge about a condition or thing
- provides basic information for a greater understanding of concepts; not intended for making a clinical decision about a specific patient
- typically found in textbooks, guidelines, point-of-care monographs, and encyclopedias
- contain two essential components: Example: What causes migraines? or How often should women over the age of 40 have a mammogram?
- A question root (who, what, when, etc.) with a verb
- A disorder, test, treatment, or other aspect of healthcare
Foreground questions – the “trees” (focused in scope)
- seek specific knowledge to inform clinical decisions or actions
- require a grasp of basic concepts to fully comprehend
- typically found in journals and conference proceedings
- contain 3-4 essential components (see PICO)
Content based on the nursing research guide at Oregon Health and Science University Library, created by Loree Hyde.
Typically used in evidence-based medicine, the PICO model is a useful way of formulating client, community, or policy-related research questions.
| P = Problem | How would I describe the problem, population, or patients? |
| I = Intervention | What main intervention, prognostic factor or exposure am I considering? |
| C = Comparison | Is there an alternative to compare with the intervention? |
| O = Outcome | What do I hope to accomplish, measure, improve or affect? |
Example PICO-based research questions:
In patients with acute bronchitis, do antibiotics reduce sputum production, cough, or days off?
Among family members of patients undergoing diagnostic procedures, does standard care, listening to tranquil music, or audio-taped comedy routines make a difference in the reduction of reported anxiety?
Original PICO model by Richardson, W.S., et al (1995). The well-built clinical question: a key to evidence-based decisions. ACP Journal Club, 123(3), A12-A13.
PICO Matrix
| P = Problem | I = Intervention | C = Comparison | O = Outcome | |
|---|---|---|---|---|
| Treatment | Disease or condition | A therapeutic measure (e.g. surgery) | Standard of care, another measure, or placebo | E.g. mortality rate, days lost from work, pain, disability |
| Prevention | Patient’s risk factors or general health condition | A preventative measure (e.g. lifestyle change) | May not apply | E.g. disease incidence, mortality rate, days lost from work |
| Diagnosis | The target disease or condition | A diagnostic test or procedure | The current “gold standard” for the problem | E.g. survival rates, mortality rates, rates of disease progression |
| Prognosis | The main prognostic factor or clinical problem in terms of severity, duration | The exposure of interest is usually *time* | Usually does not apply. Identify the standard treatment if your question is about “watchful waiting.” | E.g. survival rates, mortality rates, rates of disease progression |
| Etiology or Harm | Patient’s risk factors, current health disorders, or general health condition | The exposure of interest, including some indication of strength and duration | May not apply | E.g disease incidence, rates of disease progression, mortality rates |
From Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.
PICO prompts
Fill in the blanks with information from your practice scenario:
THERAPY
In_______________, what is the effect of ________________on _______________ compared with _________________?
PREVENTION
For ___________ does the use of _________________ reduce the future risk of ____________ compared with ______________?
DIAGNOSIS OR DIAGNOSTIC TEST
Are (Is) ________________ more accurate in diagnosing _______________ compared with ____________?
PROGNOSIS
Does ____________ influence ______________ in patients who have _____________?
ETIOLOGY
Are ______________ who have _______________ at ______________ risk for/of ____________ compared with _____________ with/without______________?
MEANING
How do _______________ diagnosed with _______________ perceive __________________?
