Next, determine what type of question you have. This will help you phrase your clinical question and determine which study design is best for your question type.
Your patient is an 11 month old male who has been admitted to the inpatient wards with severe respiratory syncytial virus (RSV). In addition to standard medical care, the resident wonders if treating with nebulized hypertonic saline would reduce hospital stay. What does the evidence say?
P: infants with respiratory syncytial virus (RSV)
I: nebulized hypertonic saline
C: standard medical care
O: hospital stay
A 14 year-old girl presents with bloody diarrhea and abdominal pain. She is admitted for workup of inflammatory bowel disease (IBD) and potential diagnostic endoscopy/ colonoscopy. The attending suggests a fecal calprotectin test but another resident suggests fecal calgranulin C instead. They ask you to research the evidence.
P: children with bloody diarrhea and abdominal pain
I: fecal calgranulin C
C: fecal calprotectin
O: detection of inflammatory bowel disease (IBD)
14 year old female with no formal PMHx presenting to outside hospital via EMS with suspected anaphylaxis. Prior to arrival, patient was walking barefoot outside and felt the urge to urinate, lost consciousness, foaming at the mouth, facial swelling, emesis, diarrhea, hives, and agitation. Mother stated that patient endorsed shortness of breath during transport via EMS. Patient’s B/P was initially stable, but later dropped 73/43. Started on 0.02 epi drip and weaned to 0.01 and was given normal saline bolus x1. Patient was then transferred to the PICU for further evaluation. Stabilized and was transferred to our care.
P: Pediatric patients seen for anaphylaxis
I: Glucocorticoids following discharge
C: No glucocorticoids following discharge
O: Readmission for anaphylaxis
A 9-year-old female with juvenile dermatomyositis currently treated with IVIG, methotrexate, folic acid, and prednisone 30mg BID presents with a dermatomyositis flare. During her hospital course, she was treated with pulsed solumedrol. Her dad raised concerns for her bone health due to her history of steroid therapy for the last 1.5 years. The clinical team considered the utility of a DEXA scan as an outpatient referral to manage fracture risk in this child.
P: Adolescents on long-term corticosteroids
I: DEXA scan
C: No imaging
O: Fracture risk
P: school age children
I: formula fed (as infants)
C: breastfed (as infants)
with/without ___ (C)?