Defining the Clinical Question

A 52-year-old African American man has a family history of myocardial infarction in a brother at age 48 and in his father at age 57. He has a personal history of hypertension well controlled by lisinopril , a low HDL cholesterol (32 mg./dl.) and a moderately elevated LDL cholesterol (156 mg./dl.). He has no other cardiac risk factors. He is concerned about some recent weight gain and is thinking about abandoning his habit of having two beers each day after work. However, he has heard that moderate use of alcohol actually might reduce his risk of heart attack. He asks his physician about the role of alcohol in modifying his chances of having a myocardial infarction.

Read the case above and formulate an appropriate specific clinical question. Get help on developing a Well-Built Clinical Question.

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A well-built clinical question on etiology:

  1. Describes the key features of the patient (and their disease if indicated) that could be relevant to health risks:


    You will use these features to compare your patient to study populations to determine if the research results can be generalized to your patient.


  2. Describes risk factors related to the outcome of concern
    It's important to keep in mind a patient's complete risk profile for a disease when assessing the applicability of a study focused on one risk factor.


  3. Identifies the etiological factor or exposure
    A clinical question should carefully specify the exposure including some measurement of its severity.


  4. Specifies the disease that might be caused (or prevented) by the exposure or risk factors
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