Grades and Levels of Evidence: Difference between revisions
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== Levels of Evidence<br> == | == Levels of Evidence<br> == | ||
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| Analysis with no sensitivity analysis<br> | | Analysis with no sensitivity analysis<br> | ||
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| 5<br> | | '''5'''<br> | ||
| <br> | | Expert opinion without explicit critical appraisal, or based on physiology, bench research or "first principles"<br> | ||
| <br> | | Expert opinion without explicit critical appraisal, or based on physiology, bench research or "first principles"<br> | ||
| <br> | | Expert opinion without explicit critical appraisal, or based on physiology, bench research or "first principles"<br> | ||
| <br> | | Expert opinion without explicit critical appraisal, or based on physiology, bench research or "first principles"<br> | ||
| <br> | | Expert opinion without explicit critical appraisal, or based on physiology, bench research or "first principles"<br> | ||
|} | |} | ||
Produced by Bob Phillips, Chris Ball, Dave Sackett, Doug Badenoch, Sharon Straus, Brian Haynes, Martin Dawes since November 1998. Updated by Jeremy Howick March 2009. | |||
== Grades of Evidence == | == Grades of Evidence == |
Revision as of 16:45, 8 June 2009
Original Editor - Tyler Shultz
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Discussion & Background[edit | edit source]
Levels of Evidence
[edit | edit source]
Level |
Therapy/Prevetion, Aetiology/Harm |
Prognosis |
Diagnosis |
Differential Diagnosis |
Economic and Descision Analysis |
1A |
SR (with homogeneity) of RCTs |
SR (with homogeneity) of inception cohort studies; CDR validated in different populations |
SR (with homogeneity) of Level 1 diagnostic studies; CDR with 1b studies from different clinical centres |
SR (with homogeneity) of prospective cohort studies |
SR (with homogeneity) of Level 1 economic studies |
1B |
Individual RCT (with narrow Confidence Interval) |
Individual inception cohort study with > 80% follow-up; CDR validated in a single population |
Validating cohort study with good reference standards; or CDR tested within one clinical centre |
Prospective cohort study with good follow-up |
Analysis based on clinically sensible costs or alternatives; systematic review(s) of the evidence; and including multi-way sensitivity analyses |
1C |
All or none series |
All or none case serires |
Absoulute SpPins and SnNouts |
All or none case series |
Absolute better-value or worse-value analyses |
2A |
SR (with homogeneity) of cohort studies |
SR (with homogeneity) of either retrospective cohort studies or untreated control groups in RCTs |
SR (with homogeneity) of Level >2 diagnostic studies |
SR (with homogeneity) of 2b and better studies |
SR (with homogeneity) of Level >2 economic studies |
2B |
Individual cohort study (including low quality RCT; e.g., <80% follow-up) |
Retrospective cohort study or follow-up of untreated control patients in an RCT; Derivation of CDR or validated on split-sample only |
Exploratory cohort study with good reference standards; CDR after derivation, or validated only on split-sample or databases |
Retrospective cohort study, or poor follow-up |
Analysis based on clinically sensible costs or alternatives; limited review(s) of the evidence, or single studies; and including multi-way sensitivity analyses |
2C |
"Outcomes" Research; Ecological studies |
"Outcomes" Research |
Etiological Studies |
Audit or outcomes research | |
3A |
SR (with homogeneity) of case-control studies |
SR (with homogeneity) of 3b and better studies |
SR (with homogeneity) of 3b and better studies |
SR (with homogeneity) of 3b and better studies | |
3B |
Individual Case-Control Study |
Non-consecutive study; or without consistently applied reference standards |
Non-consecutive cohort study, or very limited population |
Analysis based on limited alternatives or costs, poor quality estimates of data, but including sensitivity analyses incorporating clinically sensible variations. | |
4 |
Case-series (and poor quality cohort and case-control studies) |
Case-series (and poor quality prognostic cohort studies) |
Case-control study, poor or non-independent reference standard |
Case-series or superseded reference standards |
Analysis with no sensitivity analysis |
5 |
Expert opinion without explicit critical appraisal, or based on physiology, bench research or "first principles" |
Expert opinion without explicit critical appraisal, or based on physiology, bench research or "first principles" |
Expert opinion without explicit critical appraisal, or based on physiology, bench research or "first principles" |
Expert opinion without explicit critical appraisal, or based on physiology, bench research or "first principles" |
Expert opinion without explicit critical appraisal, or based on physiology, bench research or "first principles" |
Produced by Bob Phillips, Chris Ball, Dave Sackett, Doug Badenoch, Sharon Straus, Brian Haynes, Martin Dawes since November 1998. Updated by Jeremy Howick March 2009.
Grades of Evidence[edit | edit source]
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]