1. What are the five steps of the evidence-based practice (EBP) process? Explain each step briefly. - The five steps are: ask a clinical question, acquire relevant evidence, appraise the evidence, apply the evidence, and assess the outcomes. - Ask a clinical question: formulate a clear and focused question that is relevant to the patient's problem or need. - Acquire relevant evidence: search for the best available evidence from various sources, such as databases, journals, guidelines, or experts. - Appraise the evidence: critically evaluate the quality, validity, reliability, and applicability of the evidence to the clinical question and the patient's situation. - Apply the evidence: integrate the evidence with the clinician's expertise, the patient's preferences and values, and the context and resources of the practice setting. - Assess the outcomes: monitor and evaluate the effects of the evidence-based intervention on the patient's outcomes, such as health status, satisfaction, or quality of life. 2. What is the difference between a background question and a foreground question? Give an example of each type of question. - A background question is a general question that seeks to understand a topic or concept, such as definitions, causes, risk factors, or treatments. It usually has two components: a question root (who, what, when, where, how, why) and a disorder or aspect of a disorder. For example: What is sepsis? How does it affect the body? - A foreground question is a specific question that seeks to inform a clinical decision or action, such as diagnosis, prognosis, therapy, or prevention. It usually has four components: a population or patient group, an intervention or exposure, a comparison or alternative, and an outcome. For example: In patients with sepsis, does early goal-directed therapy compared to standard care reduce mortality? 3. What is the PICO(T) framework? How can it help to formulate a foreground question? - The PICO(T) framework is a mnemonic that stands for: Population/Patient/Problem, Intervention/Indicator/Exposure, Comparison/Control/Comparator, Outcome/Effect/Endpoint, and (optionally) Time/Type/Setting. It can help to formulate a foreground question by breaking it down into its key elements and making it more focused and specific. - For example: In adult patients with type 2 diabetes (P), does metformin (I) compared to sulfonylureas (C) reduce the risk of cardiovascular events (O) over a 5-year period (T)? 4. What are some common sources of bias in clinical research? How can they affect the validity and reliability of the evidence? - Bias is any systematic error or deviation from the truth that can affect the design, conduct, analysis, or interpretation of a study. Some common sources of bias are: