formulating clinical question and searching the medical literature
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Formulating Clinical Question AND Searching The Medical Literature. Session Objectives. By the end of this session and your practical training you will be able to: recognize your knowledge gap, when facing clinical problem Formulate clinical questions according to your learning needs

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Presentation Transcript
session objectives
Session Objectives
  • By the end of this session and your practical training you will be able to:
    • recognize your knowledge gap, when facing clinical problem
    • Formulate clinical questions according to your learning needs
    • Understand the necessary steps you take to solve the problem?
    • Know electronic medical resources you use to gain knowledge?
clinical scenario
Clinical scenario
  • Your patient is a three years old male, presented to the ER with Purpura, mild gum bleeding
  • The patient is clinically stable, and his physical examination is otherwise normal
  • Complete blood count is totally normal apart from severe thrombocytopenia ( platelet count<10000/mm).
  • You decided to admit the child and start treatment with intravenous immunoglobulin.
  • One student asked you if treatment with pulsed high dose methyl-prednisolone would result in similar improvement at much lower cost for the hospital?
types of questions raised
Types of questions raised
  • What is idiopathic thrombocytopenic purpura
  • What is the clinical signs and symptoms?
  • How can we diagnose this disease?
  • What are the treatment options for ITP?

Background Questions

back ground questions
Back ground questions
  • When you need to know more information about the disease
types of questions raised1
Types of questions raised
  • In child suffering from ITP does treatment with steroids, compared to IVIG results in rapid cure
  • In children suffering from ITP is complete blood picture as accurate as bone marrow aspirate in diagnosis.

Foreground question

foreground questions
Foreground questions
  • When you need to know information that you will:
    • Tell your patient about
    • Decide on his management
      • Usually related to
        • Diagnosis
        • Therapy
        • Prognosis
        • harm
your therapy question the pico

Patient/

Population

Intervention/

Exposure

Comparison

Outcome

Your Therapy QuestionThe PICO

Steroids

IVIG

Child with

acute ITP

Rapid cure

your diagnosis pico question

Patient/

Population

Intervention/

Exposure

Comparison

Outcome

Your Diagnosis PICO Question

Child with

Acute ITP

Blood

picture

Bone

marrow

Accurate

diagnosis

your prognosis pico question

Patient/

Population

Intervention/

Exposure

Comparison

Outcome

Your Prognosis PICO Question

Child with

Acute ITP

Risk of

being chronic

ITP

your harm pico question

Patient/

Population

Intervention/

Exposure

Comparison

Outcome

Your Harm PICO Question

Febrile

child

Aspirin

Gastric ulcer

basic search terms
Basic Search Terms
  • Pick up important elements in your question
    • ITP
    • IVIG
    • Steroids
    • child

Start your search

online resources
Online Resources
  • Cochrane abstracts
  • Guidelines websites
  • Medline
  • Search engines
tripdatabase
TRIPdatabase

www.tripdatabase.com

search limits
Search limits
  • Search by phrase
  • Use AND, OR, NOT
  • Use Pubmed limits
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