Using Quantitative Research for Evidence Based Practice

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tips_on_formulating_answerable_questions.docx

Tips on Formulating Answerable Questions:

Read the following Case Scenario:

Emma is a 49 year old married mother of two children. She worked full time and as part of her job she drove extensively all over the state. On average she would drive 1,500 miles a week in her company car. In June of last year she had a road traffic accident. Since the accident, she is too afraid to drive, is very anxious, has frequent nightmares when she travelled as a passenger and is on sick leave from her employer. After 6 months she sought help. You are wondering which intervention: CBT paired with EMDR or just CBT will manage to get rid of the nightmares, reduce her anxiety as a passenger and tackle her avoidance of driving.”

Think about this scenario and about what questions arise from it.

A Well-built question should have 4 components:

1. Client or Problem or Population (Description of the patient or the target disorder of interest)

2. Intervention (Exposure, Diagnostic test, Therapy, Patient perception etc.)

3. Comparison Intervention (Relevant most often when looking at therapy questions)

4. Outcome (Clinical outcome of interest to you and your patient)

The scenario above would consist of the following 4 components:

Client or Problem or Population

Intervention

Comparison Intervention

Outcome

49 year old woman with PTSD after a car accident

CBT paired with EMRD Therapy

CBT alone

reduce her anxiety as a passenger and tackle her avoidance of driving

The Question you would formulate from this scenario would be as follows:

In clients with PTSD from car accidents, does Cognitive Behavioral Therapy (CBT) paired with Eye Movement Desensitization and Reprocessing (EMRD) therapy reduce anxiety as a passenger and tackle avoidance of driving when compared with only Cognitive Behavioral Therapy (CBT)?

Other Examples of 4 components of Good Effectiveness Questions:

Client or Problem or Population

Intervention

Comparison Intervention

Outcome

65 year old man with a stroke and moderate carotid stenosis

ASA

Placebo

Stroke

Kindergarteners with articulation disorders

Individual pull-out treatment

Group pull-out treatment

Ability to consistently produce /s/

17-year-old male with a severe head injury

Cognitive rehab

No cognitive rehab

Return to work/school

Young people,

under 25 years of age

Mass media interventions effective for preventing smoking in young people

No intervention

Smoking

behavior

Low-income, sexually active adolescents

a peer-led STI prevention class

a nurse-led STI prevention class

greater client participation and satisfaction

Pregnant high-school adolescents

home visits adjunct to in school interventions

in school interventions alone

decreased dropout rate

Patients with advanced cancer

keeping a pain journal

no intervention

lower reported pain scores