The skill of creating well-focused questions can be readily learned through instruction and practice. Of course, before you ask any question it is important to give background information about the patient or problem so that your consultant understands the patient's present condition or the context of your question.
Most medical questions fall into 2 broad areas: questions about doing something (therapy or prevention) and questions about understanding something (diagnosis or prognosis). A well-focused question about therapy or prevention has two components - an intervention and an outcome. A well-focused question about diagnosis or prognosis also has two components - a finding and an outcome.
Therapy or Prevention Questions: The intervention component is what you are planning to do. For example, the intervention may be the use of a specific medication or use of a preventive strategy. The outcome component of the question is what you desire to accomplish. This can improvement in a specific condition, prevention of a disease, avoiding toxicity with a specific therapy, or maximizing quality of life.
Diagnosis or Prognosis Questions: The finding component is what the physicians is trying to interpret. The finding can be something on the history or physical exam, from a lab test, or about an exposure. The outcome component of the question is what you desire to understand or predict. This can be diagnosis of a specified disease, the accuracy of a test or the prognosis of a condition.
Thus, the question "Could you tell me more about homocysteine?" is not a well-focused question. In contrast, the question "Has reducing high homocysteine levels been shown to reduce a patient’s risk of MI?" contains both an intervention (reducing high homocysteine levels) and outcome (reduced risk of MI). This is a well-focused question. Similarly, the question "Does a high homocysteine level increase the risk of MI?" contains both a finding (high levels of homocysteine) and an outcome (increased risk of MI)
It is often useful to break a complex and vague question down into several shorter and more precise questions. Building well-focused questions might take extra effort but vague questions rarely have precise answers. A mnemonic for remembering how to build a well-focused question is IOWA (questions with an
Intervention or a finding and an Outcome are Well Answered). [HOME]