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- Evidence Pyramid
- Filtered Information
- Systematic Reviews/Meta-Analyses
- Critically-Appraised Topics (Synthesis)
- Critically-Appraised Articles (Synopsis)
- Unfiltered Information
- Randomized Controlled Trials
- Cohort Studies
- Case-Controlled Studies/ Case Series and Reports
- Background Info/ Expert Opinion
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- The best evidence is located at the top of the pyramid.
- Click on one of the sources of evidence to learn more.
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- Appraise and/or synthesize information from previous studies
- Organize it into a single coherent analysis
- Provide recommendations for future practice.
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- Systematic reviews
- Comprehensively synthesize and critically appraise information from
various articles that meet specific selection criteria
- Provide recommendations based on the best evidence available
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- Meta-analyses
- Are systematic reviews using statistical methods to quantitatively
combine and summarize several studies’ results
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- Briefly evaluate and synthesize results from several studies on a
particular topic that provide the best available evidence relevant to
answering a specific clinical question
- Less rigorous than systematic reviews/meta-analyses
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- Provide a brief synopsis and appraisal of a single study that provides
evidence relevant to answering a specific clinical question
- Less rigorous than systematic reviews/meta-analyses
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- The evidence sources from which the above ones acquire their information
(i.e. the primary sources)
- Useful when filtered information is not available
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- Randomly assigns subjects into a treatment group or a control group in
order to compare the efficacy of a particular treatment, diagnosis, etc.
against the current standard, a placebo, or no intervention at all.
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- Compare two groups of subjects over time, one having a particular
condition or receiving a particular treatment, the other not
- Often used when a randomized controlled trial would be unreasonable or
unethical.
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- Retrospective observational studies of a particular diagnosis or
exposure
- Determine commonalities in
medical history or other associations amongst the affected
- Can establish correlations, but cannot prove causation
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- Based on clinical experience and case studies
- Varies in level of scientific rigor and usefulness.
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- Search Basics & Using PubMed
- More Advanced Searches & Using the Cochrane Library
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- Online Resources:
- PubMed
- Cochrane Library
- Selected Readings:
- Systematic Reviews: Synthesis of Best Evidence for Clinical Decisions by
Cook, D. J., et al.
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- From Duke University Medical Center Library and Health Sciences Library,
UNC-Chapel Hill
- From Yale University School of Medicine
- Evidence Pyramid from a Slightly Different Perspective
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