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Information In Practice

A taxonomy of generic clinical questions: classification study

BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7258.429 (Published 12 August 2000) Cite this as: BMJ 2000;321:429
  1. John W Ely, associate professor (john-ely{at}uiowa.edu)a,
  2. Jerome A Osheroff, director of informaticsb,
  3. Paul N Gorman, assistant professorc,
  4. Mark H Ebell, associate professord,
  5. M Lee Chambliss, assistant clinical professore,
  6. Eric A Pifer, assistant professor of medicinef,
  7. P Zoe Stavri, assistant professorg
  1. a Department of Family Medicine, 01291-D PFP, University of Iowa College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242-1097, USA
  2. b Praxis Press, 36 W 25th Street, 7th Floor, New York, NY 10010, USA
  3. c Division of Medical Informatics and Outcomes Research, Oregon Health Sciences University, 3181 SW Sam Jackson Park Road, Portland, OR 97201, USA
  4. d Department of Family Practice, Michigan State University, B101 Clinical Center, East Lansing, MI 48824-1315, USA
  5. e Moses Cone Family Medicine Residency, 1125 N Church Street, Greensboro, NC 27401, USA
  6. f Presbyterian Medical Center, 39th and Market Streets, Medical Arts Building, Suite 102, Philadelphia, PA 19104, USA
  7. g School of Information Resources and Library Science, University of Arizona, 1515 East First Street, Tucson, AZ 85719, USA
  1. Correspondence to: J W Ely
  • Accepted 22 May 2000

Abstract

Objective: To develop a taxonomy of doctors' questions about patient care that could be used to help answer such questions.

Design: Use of 295 questions asked by Oregon primary care doctors to modify previously developed taxonomy of 1101 clinical questions asked by Iowa family doctors.

Setting: Primary care practices in Iowa and Oregon.

Participants: Random samples of 103 Iowa family doctors and 49 Oregon primary care doctors.

Main outcome measures: Consensus among seven investigators on a meaningful taxonomy of generic questions; interrater reliability among 11 individuals who used the taxonomy to classify a random sample of 100 questions: 50 from Iowa and 50 from Oregon.

Results: The revised taxonomy, which comprised 64 generic question types, was used to classify 1396 clinical questions. The three commonest generic types were “What is the drug of choice for condition x?” (150 questions, 11%); “What is the cause of symptom x?” (115 questions, 8%); and “What test is indicated in situation x?” (112 questions, 8%). The mean interrater reliability among 11 coders was moderate (κ=0.53, agreement 55%).

Conclusions: Clinical questions in primary care can be categorised into a limited number of generic types. A moderate degree of interrater reliability was achieved with the taxonomy developed in this study. The taxonomy may enhance our understanding of doctors' information needs and improve our ability to meet those needs.

Footnotes

  • Funding This study was supported by a grant (G9518) from the American Academy of Family Physicians Foundation.

  • Competing interests None declared.

  • Embedded Image A list of the taxonomy of generic clinical questions appears on the BMJ's website

  • Accepted 22 May 2000
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