A taxonomy of generic clinical questions: classification study

Objective To develop a taxonomy of doctors' questions about patient care th at 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 fami ly doctors. Setting Primary care practices in Iowa and Oregon. Participants Random samples of 103 Iowa family doctors and 49 Oregon primar y care doctors. Main outcome measures Consensus among seven investigators on a meaningful t axonomy of generic questions; interrater reliability among 11 individuals w ho 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, wa s used to classify 1396 clinical questions. The three commonest generic typ es 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 in dicated in situation x?"(112 questions, 8%). The mean interrater reliabilit y among 11 coders nas moderate (kappa = 0.53, agreement 55%). Conclusions Clinical questions in primary care can be categorised into a li mited number of generic types. A moderate degree of interrater reliability was achieved with the taxonomy developed in this study, The taxonomy may en hance our understanding of doctors' information needs and improve our abili ty to meet those needs.