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Evidence-Based Clinical Practice: Acquiring evidence using databases

Evidence pyramid


 Levels of Evidence Pyramid by Krystal Bullers is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Levels of Evidence

Categories of evidence are conceptualized as a hierarchy, with the top levels considered the best evidence for clinical decision-making. These higher levels are considered secondary literature, which synthesizes, filters, and evaluates the primary (lower level) literature. The hierarchy can include:

  • Clinical Practice Guidelines
  • Systematic Reviews: A review of all research available on a given topic, conducted with strict methods of locating and synthesizing the research.
  • Systematic Reviews with Meta-Analyses: Reviews that pool and summarize the data from each study included in the review.
  • Randomized Controlled Trials: A study wherein the subjects are divided into two groups: one that received the genuine treatment, and one that receives a placebo treatment.
  • Case-Controlled Studies: A study that compares groups with differing outcomes with respect to their exposure to a suspected causal attribute.
  • Cohort Studies: A study that compares outcomes between two groups studied over a period of time.
  • Case Series: A study that measures the outcome of a group of patients who receive the same treatment, with no control group.
  • Case Reports: Reports on the treatment and outcome of a single patient.
  • Expert Opinion

 

Database tutorials

Sources of filtered information

Filtered sources are secondary sources that have been appraised by experts and summarize and synthesize the available evidence.

Sources of unfiltered information

Unfiltered sources are primary sources that describe original research.