9.1.2 Different Types of Clinical Questions

Recognises and Formulates Different Types of Clinical Questions: Therapy, Harm, Aetiology, Prognosis, Diagnosis, Economic, Qualitative

Clinical questions are an important part of evidence-based practice, helping healthcare professionals to identify the best available evidence to guide their clinical decisions. Different types of clinical questions may require different approaches to searching for evidence and evaluating the results. In this teaching piece, we will explore the six different types of clinical questions and provide guidance on how to recognise and formulate them.

Therapy Questions:

Therapy questions are concerned with the effectiveness of a treatment or intervention. These questions often start with “In patients with [condition], what is the effectiveness of [treatment]?” Therapy questions can be answered with randomized controlled trials (RCTs) and systematic reviews of RCTs.

Harm Questions:

Harm questions are concerned with the negative effects of a treatment or intervention. These questions often start with “What is the risk of [harmful outcome] associated with [treatment]?” Harm questions can be answered with observational studies such as cohort studies and case-control studies.

Aetiology Questions:

Aetiology questions are concerned with the causes of a disease or condition. These questions often start with “What are the risk factors for [condition]?” Aetiology questions can be answered with observational studies such as cohort studies and case-control studies.

Prognosis Questions:

Prognosis questions are concerned with the likely course of a disease or condition. These questions often start with “What is the likelihood of [outcome] in patients with [condition]?” Prognosis questions can be answered with cohort studies and systematic reviews of cohort studies.

Diagnosis Questions:

Diagnosis questions are concerned with the accuracy of a diagnostic test or procedure. These questions often start with “What is the accuracy of [diagnostic test/procedure] for the diagnosis of [condition]?” Diagnosis questions can be answered with diagnostic accuracy studies and systematic reviews of diagnostic accuracy studies.

Economic Questions:

Economic questions are concerned with the cost-effectiveness of a treatment or intervention. These questions often start with “What is the cost-effectiveness of [treatment] compared to [alternative treatment]?” Economic questions can be answered with economic evaluations such as cost-effectiveness analyses and systematic reviews of economic evaluations.

Qualitative Questions:

Qualitative questions are concerned with exploring the experiences, perceptions, and attitudes of patients, healthcare professionals, and other stakeholders. These questions often start with “What are the experiences of [patient group/healthcare professionals] with [condition/treatment]?” Qualitative questions can be answered with qualitative research methods such as interviews and focus groups.

Type of Clinical Question	Examples of Question Starters	Study Designs to Answer Question
Therapy	In patients with [condition], what is the effectiveness of [treatment]?	Randomized controlled trials (RCTs) and systematic reviews of RCTs
Harm	What is the risk of [harmful outcome] associated with [treatment]?	Observational studies such as cohort studies and case-control studies
Aetiology	What are the risk factors for [condition]?	Observational studies such as cohort studies and case-control studies
Prognosis	What is the likelihood of [outcome] in patients with [condition]?	Cohort studies and systematic reviews of cohort studies
Diagnosis	What is the accuracy of [diagnostic test/procedure] for the diagnosis of [condition]?	Diagnostic accuracy studies and systematic reviews of diagnostic accuracy studies
Economic	What is the cost-effectiveness of [treatment] compared to [alternative treatment]?	Economic evaluations such as cost-effectiveness analyses and systematic reviews of economic evaluations
Qualitative	What are the experiences of [patient group/healthcare professionals] with [condition/treatment]?	Qualitative research methods such as interviews and focus groups

Recognising and formulating different types of clinical questions is important for guiding evidence-based practice. By understanding the different types of clinical questions and the study designs that can be used to answer them, healthcare professionals can identify the best available evidence to guide their clinical decisions.

In conclusion, recognising and formulating different types of clinical questions is important for guiding evidence-based practice. Different types of clinical questions require different approaches to searching for evidence and evaluating the results. By understanding the different types of clinical questions, healthcare professionals can identify the best available evidence to guide their clinical decisions.

References:

1. Straus, S. E., Glasziou, P., Richardson, W. S., & Haynes, R. B. (2018). Evidence-based medicine: how to practice and teach EBM (5th ed.). Elsevier.