Skip to Main Content

Occupational Therapy

Background vs. Foreground Questions

What is the difference between background and foreground questions?

Background Questions Foreground Questions
  • More general
  • Begin with how, what, why, when, where or ask about some aspect of patient care
  • Asked when you don't know much about the topic, and need information get started
  • Too general for a research topic
  • NOT good for a PubMed search


  • What is the best treatment for...?
  • How do you diagnose...?
  • What are the risk factors for...?
  • What are the symptoms of...? 
  • More specific
  • Usually relate to a specific patient, population, or treatment
  • Uses the PICO acronym to narrow and define the question
  • One of four content areas: treatment, diagnosis, etiology, and prognosis
  • Good for a research topic or a specific patient's case
  • Good for a PubMed search


  • Would massage therapy be effective at reducing chronic low pain back in otherwise healthy adults?

Literature resources:

  • Textbooks
  • Point of Care resources such as Clinical Key, Natural Medicines

Literature resources:

  • Research databases such as PubMed, Ovid, CINAHL


Using PICO to Formulate Clinical Foreground Questions

PICO is a mnemonic used to describe the four elements of a good clinical question that is neither too broad nor too narrow. It stands for:

- Patient/Problem/Population
I - Intervention
C - Comparison
O - Outcome
(T) -
 Time (when applicable)

"How effective is the consumption of low glycemic index foods for reducing energy intake and promoting weight loss in adults?

Population Adults
Intervention Consumption of low glycemic index foods
Comparison No comparison

Weight loss, and reduced energy intake


Topic Too Narrow or Too Broad

Your topic needs to be scalable to your paper. Make sure it isn’t too broad or too narrow. If you notice any of the following while searching for articles and books, you may need to refine your topic. 

Too Broad? Too Narrow?
can be summed up in one or two words difficult to figure out where you would locate information (e.g., data may not exist)
difficult to come up with a thesis statement hard to research because there is so little information (e.g., you only found 3 or 4 results in your searching)
hard to research because there is so much information (e.g., you found 1000s of hits in your searching)  

Too broad:

"Is Medical Nutrition Therapy effective?"

Apply journalistic question words to your topic to narrow your focus. (e.g., “Global Warming” > “Global Warming on reptiles in Australia” = what, where)

Who | What | Where | When | Why | How

Too narrow:

"Is a one-shot motivational interviewing session effective for reducing after-school soda consumption among teens?"

Remove one aspect of your topic and/or use the question words to back up a step.