Pyramid of Evidence (5S Model)
Source: EBM levels of evidence. EBM Pyramid and EBM Page Generator, 2006 [?] Trustees of Dartmouth College and Yale University. All Rights Reserved. Produced by Jan Glover, David Izzo, Karen Odato, and Lei Wang.
The Haynes 6S evidence model has an additional layer at the top of the pyramid for SYSTEMS (where evidence is integrated within clinical decision making systems).
Image adapted from: Guide to Research Methods :The Evidence Pyramid, SUNY Downstate Medical Center. Viewed online 03/02/2020.
Guide to study types to match clinical questions.
Type of question
|
Ideal type of study
|
Therapy
|
Randomised control trial RCT
|
Prevention
|
RCT | Cohort Study | Case Control
|
Diagnosis
|
Prospective, blind controlled trial comparison to gold standard
|
Prognosis
|
Cohort study | Case Control | Case series or Case report
|
Etiology/Harm
|
RCT | Cohort study | Case control
|
Cost analysis
|
Economic analysis
|
Comparative effectiveness research (CER) is the conduct and synthesis of research comparing the benefits and harms of different interventions and strategies to prevent, diagnose, treat and monitor health conditions in "real world" settings.
Source - Definition: NLM Resources for Informing Comparative Effectiveness. Viewed on 3/03/2020.
Check the EQUATOR Network website for more guidelines for specific research methods.
NHMRC Levels of Evidence
Table 1.3 Designation of levels of evidence: Levels of evidence Study design. Evidence obtained from:
I Systematic review of RCTs
II At least one RCT
III-1 Pseudorandomised controlled trials
III-2 Comparative studies with concurrent controls and allocation not randomised
III-3 Comparative studies with historical control or interrupted time series without a parallel control group
IV Case series, either post-test or pretest/post-test
Source: NHMRC (1999) How to Use the Evidence p.8. Viewed 23/07/2015
For information about systematic reviews, see the following selected sites.