Evidence-Based Medicine Hierarchy
Editorials, Expert Opinion
These are simply the opinions of respected healthcare professionals, based on their own clinical experience and expertise.
Case Series, Case Reports
These are descriptive reports of patients with the outcome of interest. No control group and no experimentation are involved.
Case-Control Studies
Case-Control studies look at patients who have the outcome of interest and then look at their past histories to see if they had the exposure of interest. These are prone to error because the rely on patients' memories.
Cohort Studies
A comparative study of two groups of patients, one who recieved the treatment of interest and one that did not. Participants are naturally part of their groups and are not assigned or randomized in any way.
Randomized Controlled Trials
In a randomized controlled trial participants are randomly assigned to either the experimental group or the control group. The randomness prevents bias.
Systematic Reviews
Authors of a systematic review try to find all available research on a topic, both published and unpublished, and combine it into a single analysis of the topic. Meta-analysis is a specific type of systematic review, but for your purposes they may be used interchangably.
**The image above comes from the Library of the Health Sciences - Chicago at the University of Illinois at Chicago.
Why EBM?
Why practice Evidence-Based Medicine? Search these databases to find out.
- Credo Reference
Search for evidence-based medicine or evidence-based practice. - Nursing Resource Center Search for evidence-based medicine, and then choose "related articles" in the results list.
- CINAHL Search the CINAHL Headings for evidence-based, and explode the topic.
6 Steps of EBM
Step one
Decide what information is needed.
Step two
Formulate one's information needs in the form of a question.
Step three
Search the published literature to find the evidence.
Step four
Decide which studies are valid and applicable to the patient at hand.
Step five
Apply the findings to the patient.
Step six
Evaluate the outcomes.
Sox, Harold C. "Evidence-Based Medicine." Encyclopedia of Public Health. Ed. Lester Breslow. Vol. 2. Detroit: Macmillan Refernce USA, 2002. Nursing Resource Center. Gale. Horry-Georgetown Technical College. 21 Jan. 2010.
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