In evidence-based practice (EBP), the focus is on translating the best available evidence into clinical decision-making to improve patient care. Unlike traditional research, which aims to generate new knowledge or validate existing theories through systematic and rigorous methods, EBP integrates clinical expertise, best evidence, patient preferences, and values.
The process starts with a clinical question, which can be either a background question that seeks general knowledge or a foreground question that seeks specific knowledge to inform clinical decisions. This distinction guides the search and application of research evidence to clinical decision-making.
Background questions are general knowledge questions that often ask about the basic information concerning a condition, disease or treatment. These questions aim to provide foundational information and understanding about a topic.
For example:
"What are the symptoms of heart failure?"
"How do I insert a jugular venous central line?"
“What are the side effects of taking this medicine?”
Foreground questions are specific, focused questions that are used to guide the search for evidence in order to make clinical decisions. These questions are typically structured using the PICO framework to specify the patient or problem, intervention, comparison and outcome.
For example:
In patients with type 2 diabetes (P), does metformin (I) compared to sulfonylureas (C) result in better glycemic control (O)?
Scope: Background questions are broad and seek general knowledge, while foreground questions are specific and focused on finding detailed evidence to guide clinical decisions.
Structure: Foreground questions are often structured using the PICO(T) format to clarify all relevant aspects of the clinical scenario.
Both types of questions are essential in EBP. Background questions help build foundational understanding, while foreground questions guide the critical appraisal and application of research evidence to individual patient care decisions.
Textbooks and review articles are the quickest places to find direct and reliable answers to background questions.
This includes: