Evidence-Based Dentistry: ASK- The Clinical Question

STEP ONE 

ASK is your clinical question a background or foreground question ?

Background questions are general knowledge questions and tend to ask who, what, where, when and why. For instance, what causes dental caries?  Typically background questions can be answered with textbooks or clinical guidelines.

Foreground questions are the core of the EBD process.  They require specific knowledge to decide and inform on  a clinical decision as it applies to  a particular patient or population.  

If you are not certain if your question is a background or foreground question consider, “Did I know the answer to this question at the end of the first year of dental school?” If the answer is yes, it is most likely a background question.

Reference:

Evidence-Based Medicine How to Practice and Teach EBM Sackett et al (2000)

Will an occlusal splint reduce temporomandibular joint (TMJ) discomfort for an adult patient with sleep bruxism ?

EBD uses a process called PICO to aid in turning your foreground question into a searchable question.

P = Patient or Population

I = Intervention

C = Comparison

O = Outcome

Patient / population / problem: Adult with sleep bruxism

Intervention: Occlusal Splints

Comparison: No treatment

Outcome: Reduce pain

Determining the domain or category of a searchable questions is important to deciding what types of information sources may provide the  best answer  to the question.

After converting your question into PICO, determine what domain it is. The most common domains/categories are:

• Diagnosis

• Therapy

• Etiology/Harm

• Prognosis

Most EBD questions fall under Therapy.