"the integration of best research evidence with clinical expertise and patient values." (Sackett, David L., et al., Evidence-based medicine: how to practice and teach EBM. New York: Churchill Livingstone, 2000. p. 1)
Things to remember
1) Processing information into high levels of evidence takes time, and there is no guarantee that evidence exists at all levels for a specific clinical question.
2) Start with the highest level of evidence available. High-level resources build upon resources found in the lowere levels of the pyramid to provide concise and up to date information.
3) Preappraised resources have a strict filtering process to insure that only high-quality information is included. Good resources will make their filtering processes readily available to users.
Levels of Evidence
- Systems - The highest level of evidence. Computerized decision support systems integrate and summarize all the available relevant research evidence, updates as new evidence becomes available, and automatically links relevant information to a patient's electronic medical recod.
- Summaries - Includes clinical pathways or textbook summaries. Summaries integrate evidence for specific clinical problems and regularly update as new evidence becomes available.
- Synopses of Syntheses - Comprehensive summaries of all the research related to focused clinical questions.
- Syntheses - Systematic reviews.
- Synopses of Studies - Highly detailed summaries of original high-quality single studies. Found in the evidence-based abstraction journals and are accompanied by commentaries that address the clinical applicability of a study's findings.
- Studies - Original single studies. Can be preappraised or nonappraised.