Formulating Answerable Clinical Questions

Every time we see a patient, we need new information about some element of the diagnosis, prognosis or management. Because our time to try to find this information is often limited, we need to be very efficient in our searching. To achieve this efficiency, we need to become skilled at formulating clinical questions.

Consider the questions that arise from the following scenario:

You admit a 65 year old man with a stroke. On examination you find that he has mild weakness of the right arm and right leg and bilateral carotid bruits. You send the patient for carotid doppler ultrasonography and subsequently receive the report that he has moderate stenosis (50-69% by NASCET criteria) of the ipsilateral carotid artery. You've noticed in the pile of journals that is accumulating in your office that there has been some recent literature addressing surgical versus medical therapy for patients with symptomatic carotid stenosis but you are unsure what the results of these studies indicate.

Think about this scenario and about what questions arise from it. You can use the box below to record some of them, and then you can print this page.