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Systematic Review: A summary of evidence, typically conducted by an expert or expert panel on a particular topic, that uses a rigorous process (to minimize bias) for identifying, appraising, and synthesizing studies to answer a specific clinical question and draw conclusions about the data gathered.
The levels of evidence are an important component of EBM. Understanding the levels and why they are assigned to publications and abstracts helps the reader to prioritize information. This is not to say that all level 4 evidence should be ignored and all level 1 evidence accepted as fact.
According to the Johns Hopkins hierarchy of evidence, the highest level of evidence is an RCT, a systematic review of RCTs, or a meta-analysis of RCTs. 7 In an RCT, the study must meet three criteria: random or “by chance” assignment of participants into two or more groups, an intervention or treatment applied to at least one of the groups ...
The criteria for ranking evidence is based on the design, methodology, validity and applicability of the different types of studies. The outcome is called “levels of evidence” or “levels of evidence hierarchy”.
This is a general set of levels to aid in critically evaluating evidence. It was adapted from the model presented in the book, Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice (Melnyk & Fineout-Overholt, 2019).
The levels of evidence pyramid provides a way to visualize both the quality of evidence and the amount of evidence available. For example, systematic reviews are at the top of the pyramid, meaning they are both the highest level of evidence and the least common.
Level I: Evidence from a systematic review of all relevant randomized controlled trials. Level II: Evidence from a meta-analysis of all relevant randomized controlled trials. Level III: Evidence from evidence summaries developed from systematic reviews
Evidence is ranked on a hierarchy according to the strength of the results of the clinical trial or research study. The strength of results can be impacted by a variety of factors such as the study design, outcomes, and bias, as well as the results themselves.
When searching for evidence to answer clinical questions, aim to identify the highest level of available evidence. Evidence hierarchies can help you strategically identify which resources to use for finding evidence, as well as which search results are most likely to be "best".
The following four possible levels and their definition are reported: High: High confidence that the evidence reflects the true effect. Further research is very unlikely to change our confidence in the estimate of effect. Moderate: Moderate confidence that the evidence reflects the true effect. Further research may change our confidence in the ...