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Evidence Based Practice: Ask the Question

An Interprofessional Guide

Foreground and Background Questions

“If you do not know how to ask the right question you discover nothing.”
- Attributed to W. Edwards Deming

First, reflect on what type of information you need.  Do you need a bottom line answer to a Who-What-Where-Why kind of question or do you need to know the answer to a complex clinical scenario?

Background questions

Background questions are usually broadly worded, and reflect the need to better understand a problem, need, or condition.  For example:

  • What are the causes for a vitamin B12 deficiency?
  • How is lumbar radiculopathy diagnosed?
  • What is the criteria to be considered clinically obese?

Background questions are often answered from secondary information resources.

Foreground questions:

Foreground questions require specific knowledge and include numerous clinical variables. Foreground questions are also called PICO questions. For example:

  • In long term smokers, does acupuncture, compared with other interventions, improve the chance of successfully quitting?
  • In patients with multiple sclerosis, is a manual muscle test as reliable as a hand held dyamometer for measuring quadriceps strength?
  • Does early mobilization of patients in the ICU following coronary bypass graft surgery improve patient outcomes?

If you are asking foreground questions, then you most likely need to look for the evidence in the primary literature, focusing on locating relevant journal articles.

1 Large List of Quotes by W. Edwards Deming «â€¯The W. Edwards Deming Institute Blog. (n.d.). Retrieved July 20, 2017, from

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