Pre-Clerkship Library Resources

Background and Foreground Questions

In Evidence Based Practice, there are these two types of questions.

Background Questions:

General questions that help you to build context and understanding. Answers are found in books and textbooks, clinical practice guidelines, and review articles.

Example questions:

What causes migraines? Search: cause and migraines

How is Type II Diabetes treated? Search: treatment and type 2 diabetes

What is the prognosis for stroke? Search: prognosis and stroke

Some common resources for finding answers to background questions include:

• Access Medicine (textbooks)
• Up to Date
• Essential Evidence Plus
• Review article in Pubmed

Foreground Questions:

Specific questions intended for making clinical decisions. They are specific to a patient or particular population and they usually focus on comparisons: two drugs, two treatments, two diagnostic tests, etc.

Foreground questions may be further categorized into one of 4 major types: treatment/therapy, diagnosis, prognosis, or etiology/harm.

You would search journal article databases for insight to a foreground question.

A well known model for building a clinical foreground question is called PICO. It can be a very useful strategy for organizing and focusing your question.

P - Patient/Problem/ Population

I - Intervention

C - Comparison

O - Outcome

Example question: Does hand washing (I), compared to not washing hands (C), among healthcare workers (P) reduce hospital acquired infections (O)?

Some common sources for finding answers to foreground questions include:

• PubMed
• Embase
• CINAHL
• TRIP

Go to the "Literature Search Strategies (PICO)" page to learn more