Why Levels of Evidence?
"As the name suggests, evidence-based medicine (EBM), is about finding evidence and using that evidence to make clinical decisions. A cornerstone of EBM is the hierarchical system of classifying evidence. This hierarchy is known as the levels of evidence. Physicians are encouraged to find the highest level of evidence to answer clinical questions."
Burns, P. B., Rohrich, R. J., & Chung, K. C. (2011, July). The levels of evidence and their role in evidence-based medicine. Plastic and reconstructive surgery. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124652/
Study Design & Levels of Evidence
Rating Systems for Levels of Evidence
- Johns Hopkins Evidence-Based Practice Model for Nursing and Healthcare Professionals The Johns Hopkins EBP model uses 3 ratings for the level of scientific research evidence true experimental (level I) quasi-experimental (level II) nonexperimental (level III)
Books
Evidence-Guided Practice by
Athletic trainers must have a foundation in the concepts of evidence-based practice to deliver patient care in an effective way. It is critical that students and clinicians formulate clinical plans that will be effective for individual patients. With that goal in mind, this book teaches the athletic trainer that evidence-based practice concepts must be incorporated into daily clinical practice. Written in a conversational tone, it provides a practical and concise resource for athletic trainers to use when interpreting what the available evidence means for them and how it can be effectively applied in daily patient care. The competencies within athletic training and other health care professions were considered when each chapter was constructed and special care taken to include examples that are specific to athletic training and instructional applications for educators. What Is Inside?: Types of research design. Foundations of research and statistics. Introduction to critical appraisal. Concepts of validity. Diagnostic accuracy. Disablement models. Patient-oriented outcome assessments. Health care informatics. The first of its kind, Evidence-Guided Practice is the only resource athletic training students, clinicians, or other health care professionals will need to properly put evidence-based concepts into practice.
Call Number: MAIN: RC1211 .V36Pub. date: 2015
How to Read a Paper by
The best-selling introduction to evidence-based medicine In a clear and engaging style, How to Read a Paper demystifies evidence-based medicine and explains how to critically appraise published research and also put the findings into practice. An ideal introduction to evidence-based medicine, How to Read a Paper explains what to look for in different types of papers and how best to evaluate the literature and then implement the findings in an evidence-based, patient-centred way. Helpful checklist summaries of the key points in each chapter provide a useful framework for applying the principles of evidence-based medicine in everyday practice. This fifth edition has been fully updated with new examples and references to reflect recent developments and current practice. It also includes two new chapters on applying evidence-based medicine with patients and on the common criticisms of evidence-based medicine and responses. How to Read a Paper is a standard text for medical and nursing schools as well as a friendly guide for everyone wanting to teach or learn the basics of evidence-based medicine.
Call Number: eBookPub. date: 2014
Research Methods by
Research Methods: A Framework for Evidence-Based Clinical Practice is written specifically for students and practitioners in allied health care professions that treat patients with movement limitations, such as physical therapy and athletic training. Following the text's clear, easy-to-follow guidance, readers will quickly learn how to gather, read, interpret, assess, and apply research to clinical practice. Most importantly, they will discover how an evidence-based approach will improve clinical outcomes in their own practice.
Call Number: MAIN: R850 .H87Pub. date: 2011
Users' Guides to the Medical Literature by
How to use the medical literature and this book to improve your patient care -- The philosophy of evidence-based medicine -- What is the question? -- Finding the evidence -- Why study results mislead: bias and random error -- Therapy -- Does treatment lower risk? Understanding the results -- Confidence intervals -- Advanced topics in the validity of therapy trials -- Hypothesis testing -- Advanced topics in applying the results of therapy trials -- Harm -- Advanced topics in harm -- The process of diagnosis -- Differential diagnosis -- Diagnostic tests -- Advanced topics in diagnosis -- How to critically appraise an article about prognosis -- Summarizing the evidence -- Advanced topics in systematic reviews -- How to use a patient management recommendation -- Advanced topics in moving from evidence to action.
Call Number: eBookPub. date: 2008
Systematic Reviews: Polyglot Search Translator
The Polyglot Search Translator is a tool for translating search syntax from one bibliographic database to another on a different platform eg PubMed to CINAHL (EBSCO) or Cochrane Library (Wiley).
Syntax describes the way database commands are written on each platform. For example searching for diabetes in the title of a record would look like:
- TI diabetes in CINAHL (EBSCOhost)
- diabetes:ti in the Cochrane Library (Wiley)
- diabetes[ti] in PubMed
Note: Syntax is consistent across the same platform, so there is no need to translate syntax across different databases on the same platform. For example MEDLINE, and CINAL both in EBSCO use the same syntax/command language.
IMPORTANT: Polyglot only changes to syntax/command language. It CANNOT check your choice of subject headings, and you must manually check these each database.
Searching for Levels of Evidence
The pyramid includes a variety of evidence types and levels.
- Filtered resources: pre-evaluated in some way
- systematic reviews
- meta-analysis
- critically-appraised topics
- critically-appraised individual articles
- Unfiltered resources: typically original research and first-person accounts
- randomized controlled trials
- cohort studies
- case-controlled studies, case series, and case reports
- Background information, expert opinion
Filtered Resources
The highest levels of evidence are filtered resources that are pre-evaluated. For example, systematic review ask a clinical question, conduct a comprehensive literature review, remove the poorly done studies, and make recommendations based on the well-done studies.
You can find filtered resources in these databases*:
*Other than Cochrane Review, the databases below include unfiltered resources as well.
- Cochrane Library This link opens in a new windowProvides independent evidence to inform healthcare decision-making. The library collection includes the Cochrane Database of Systematic Reviews (CDSR), the Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Clinical Answers, and a federated search feature that incorporates results from external databases.
- PubMed This link opens in a new window(Free) PubMed comprises more than 27 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites. This is a free database provided as a courtesy by the Whitworth Library, which cannot guarantee access or content.
- TRIP - Turning Research Into Practice This link opens in a new window(Free) Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care. Use the PICO search tool to find research specific to population, intervention, comparison, or outcome.
Unfiltered Resources
Unfiltered resources are articles that provide the most recent information from clinical and practice research (e.g., case studies, comparative studies, or clinical trials). Unfiltered resources, require you to evaluate each study to determine its validity and applicability to the patient or the practice question. These are resources help find answers not found in filtered resources.
You can find unfiltered resources in these databases:
- MEDLINE This link opens in a new windowEBSCO - (1950's-current) Biomedical journal abstracts for medicine, dentistry, veterinary medicine, and the health care system. Also available in public Web Version. Searches abstracts of over 4,800 current biomedical journals.
- Nursing & Allied Health Database This link opens in a new windowProQuest - Covers the fields of nursing and allied health.