Background questions are generally posed towards the basic understanding of a topic. These types of questions generally have only 2 parts: A question root (who, what, when, where, how, why) and a disorder, test, treatment, or other aspect of health care. Often these questions can best be answered by using a textbook or consulting a clinical database. Some sample background questions:
Background questions can be answered by using secondary resources such as informational articles, reference books, or clinical databases, and authoritative answers can be found in a short amount of time.
Watch this video to learn how to use the PICO method to create a searchable clinical question. On your own, practice coming up with some ideas for searchable questions.
Foreground questions, on the other hand, are much more complex. They often include a broad range of topics including biological, psychological and sociological issues. Some examples of foreground questions include:
Due to the complexity of the question, foreground questions generally require the use of scientific studies to answer, and may take much more research and time to answer.
PICO is a search strategy formula. The components of PICO help pinpoint keywords that you will be able to directly input into a database to find research. If you are unable to find articles that utilize that intervention, try using alternate terms. If that still does not work, this may mean you have stumbled upon a gap in the evidence -- it is possible that research has not been done or published on this particular topic. If you are having trouble finding literature on your topic, you can always ask a library for help.
So let’s look back at our earlier example of Tai Chi helping to reduce risk of falling
Your boolean search could look something like this:
(elderly OR geriatric OR aging OR aged) AND (“Tai chi” OR Taiji OR “Tai ji”) AND (exercise OR usual care) AND (Accidental Falls/prevention & control*)
PICO is focused around an intervention. If you are not including an intervention in your literature search, you may spend a lot of time combing through results just to discover what kinds of interventions are available, and then having to narrow down your results. This can be avoided and time can be saved by doing some background research first, understanding what types of interventions are available, and incorporating that into your search.