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INFORMATION IN PRACTICE: John W Ely, Jerome A Osheroff, Paul N Gorman, Mark H Ebell, M Lee Chambliss, Eric A Pifer, and P Zoe Stavri A taxonomy of generic clinical questions: classification study BMJ 2000; 321: 429-432 [Abstract] [Full text]

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A taxonomy of generic clinical questions

Nicky Goater   (15 August 2000)

A taxonomy of generic clinical questions 15 August 2000
Nicky Goater Send response to journal: Re: A taxonomy of generic clinical questions	Ely and colleagues (1) are quite right in their assertion that doctors often have questions relating to the care of their patients during a consultation. These questions may be fundamental to management, such as what should I prescribe?, or what are the relative merits of different modes of treatment in this case? However, in psychiatry (and I suspect other specialities) there is rarely accessible, generalisable information of a sufficient quality to guide treatment in an individual case. Having attended an 'evidence based' journal club in which the question asked was generated from the preceding case conference, I cannot recall a paper or other evidence presented which provided an answer or might influence practice. The next step must surely be an attempt to answer those important questions which recur frequently in clinical practice. Ely et al describe a method of classifying questions from many individual clinicians into a core list of question types (eg what is the cause of symptom x?). Using their classification system, questions could be collected from professionals and other genuinely interested parties, and organised into a core list of clinically relevant questions for each speciality. Surely this should be a central task of the National Institute of Clinical Excellence (NICE), and one which even the most cynical amongst us would like it to do. These questions should guide the NICE agenda, and prioritise other political initiatives, systematic reviews, and research funding, rather than politics, political correctness, or vested interest. It could even influence examinations and continuing professional development. Perhaps then 'evidence based' medicine could be a reality in some cases, and the skills necessary to apply it (which are now examined by the Royal College of Psychiatrists) would be worth learning. Dr Nicky Goater 1 Ely JW, Osheroff JA, Gorman PN, Ebell MH, Chambliss ML, Pifer EA, Stavri PZ. A taxonomy of generic clinical questions: classification study. BMJ 2000; 321: 429-432. (12 August)