Skip to Main Content
It looks like you're using Internet Explorer 11 or older. This website works best with modern browsers such as the latest versions of Chrome, Firefox, Safari, and Edge. If you continue with this browser, you may see unexpected results.

WHSL Clinical Questions using PubMed: Asking the Clinical Question

The first in a series of evidence-based medicine guides

Kinds of Clinical Questions

There are two kinds of clinical questions:

Background Questions

    • Background questions are about physiology, pathology, epidemiology, and general management
    • They are often asked when still inexperienced
    • Answers to background questions can usually be found in textbooks, narrative review articles (found via PubMed), or encyclopaedias


Foreground Questions

  • Foreground questions are more commonly asked by experienced clinicians
  • These questions are asked when browsing the literature
    • Eg. what important new information should I know about in order to treat my patient optimally?
  • These questions may also be asked when solving specific problems
    • usually in regard to patient care


The Clinical Question

Evidence-based practice requires you to

  • formulate a clear clinical question
  • search the literature for relevant clinical articles
  • appraise (analyse) the articles retrieved for validity and applicability
    • how will the result benefit my patient/s?
  • apply the evidence in practice

Framing the clinical query as a searchable statement is often the most difficult part of evidence-based searching of the literature.  It requires a synthesis of all your previously learnt search skills and knowledge of resources; together with your clinical knowledge and skills, and diagnostic acumen¹.

1. Richardson, S. 1995. The well-built clinical question: a key to evdience-based decisions. ACP Journal Club 123:A12-13.


Background Questions

Background questions are asked when you need basic, general information about a topic (who, what, when, where, how)

  • What is hypertension?
  • When should an antibiotic be prescribed?
  • How should irritable bowel syndrome be treated?

Foreground Questions

Foreground questions are specific to the particular patient or problem in your clinical scenario

  • Can antibiotics be used to treat adult pharyngitis?
  • What are the effects of inhaled corticosteroids on asthmatic children?
  • Are alternative medicine therapies better than 5-hydroxytryptamine receptor 4 (5-HT(4)) agonist for IBS?
Foreground questions are typically posed using the PICO framework to formulate the clinical question.


Using knowledge gained from your last PBL trigger, formulate

  • Two background questions on the topic
  • Two foreground questions on the topic
Use the examples provided in the boxes above to guide you in formulating these kinds of clinical questions.