*

Associate Professor Dr Moy Foong Ming

Department of Social & Preventive Medicine
Faculty of Medicine
University of Malaya

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Question

Question type

What should I do about this

condition or problem?

Intervention /
Therapeutic

What causes the problem?

Aetiology

Does this person have the

condition of problem?

Diagnosis

Who will get the condition or

problem?

Prognosis

*
*P opulation or clinical problem
*I ntervention or index test
*C omparison
*O utcome

*
*D omain population
*D eterminant
*

intervention, comparison, tests

*O utcome
*Similar to PICO

*
*Jean is a 55 year old woman who often crosses the
Atlantic to visit her elderly mother. She tends to get
swollen legs on these flights and is worried about
her risk of developing deep vein thrombosis (DVT),
because she has read a bit about this in the
newspaper lately. She asks you (as a doctor) if she
should wear elastic stockings on her next trip to
reduce her risk

Population/
problem
Intervention

Comparison/
control
Outcome

Population/
problem
Intervention

Comparison/
control
Outcome

Question

Passengers on long haul flights

Wearing elastic compression stockings

No elastic stockings

Development of DVT
In passengers on long haul flights, does
wearing elastic compression stockings,
compared with not wearing elastic
stockings, prevent DVT?
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*
*George has come to your surgery to discuss the
possibility of getting a vasectomy. He says he has
heard something about vasectomy causing an
increase in testicular cancer later in life. You
know that the risk of this is very low but want to
give him a more precise answer.

Population/
problem
Intervention

Comparison/
control
Outcome

Population/
problem
Intervention

Comparison/
control
Outcome

Question

Adult males

Vasectomy

No vasectomy

Testicular cancer
In men, does having a vasectomy (compared
with not having one), increase the risk of
getting testicular cancer in the future?
10

*
*Julie is pregnant for the second time.

She had her

first baby when she was 33 and had amniocentesis
to find out if the baby had Down Syndrome. She
didnt have a good experience as she didnt get her
results until 18 weeks pregnant. She is now 35 and
one month pregnant. She asks if she can have a
test that will give her an earlier result. The
hospital offers serum biochemistry plus nuchal
translucency ultrasound screening for Down
Syndrome. You wonder if this combination of tests
is as reliable as the conventional method.
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Population/
problem
Intervention

Comparison/
control
Outcome

12

Population/
problem
Intervention

Comparison/
control
Outcome

Question

Pregnant woman (first trimester)

Nuchal translucency ultrasound screening plus

serum biochemistry
Conventional amniocentesis

Accurate diagnosis of Down syndrome

(measured by sensitivity and specificity)
For pregnant women, is nuchal translucency
ultrasound screening plus serum biochemistry
in the first trimester as accurate (with equal or
better sensitivity and specificity) as
conventional amniocentesis for diagnosing
Down Syndrome?
13

*
*Childhood seizures are common and frightening for
the parents, and the decision to initiate
prophylactic treatment after a first fit is a difficult
one. To help parents make their decision, you
need to explain the risk of further occurrences
following a single seizure of unknown cause.

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Population/
problem
Intervention

Comparison/
control
Outcome

15

Population/
problem
Indicator
Comparison/
control
Outcome
Question

Children who have had one siezure of

unknown cause
Febrile

Non-febrile

Further seizure
In children who have had one seizure of
unknown cause (either associated with a fever
or not),what is the long term risk of further
seizures?

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Population/
problem

Children who have had one siezure of unknown

cause

Indicator

Comparison/
control
Outcome
Question

Further seizure
In children who have had one seizure of
unknown cause, what is the long term risk of
further seizures?

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*What is your clinical question?

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