For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
41
views
7
references
 Top references
cited by
357
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      275
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      New evidence pyramid

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          A pyramid has expressed the idea of hierarchy of medical evidence for so long, that not all evidence is the same. Systematic reviews and meta-analyses have been placed at the top of this pyramid for several good reasons. However, there are several counterarguments to this placement. We suggest another way of looking at the evidence-based medicine pyramid and explain how systematic reviews and meta-analyses are tools for consuming evidence—that is, appraising, synthesising and applying evidence.

          Related collections

          Most cited references7

          • Record: found
          • Abstract: found
          • Article: not found

          How to read a systematic review and meta-analysis and apply the results to patient care: users' guides to the medical literature.

          Mohammad Hassan Murad, Victor Montori, John Ioannidis … (2014)
          Clinical decisions should be based on the totality of the best evidence and not the results of individual studies. When clinicians apply the results of a systematic review or meta-analysis to patient care, they should start by evaluating the credibility of the methods of the systematic review, ie, the extent to which these methods have likely protected against misleading results. Credibility depends on whether the review addressed a sensible clinical question; included an exhaustive literature search; demonstrated reproducibility of the selection and assessment of studies; and presented results in a useful manner. For reviews that are sufficiently credible, clinicians must decide on the degree of confidence in the estimates that the evidence warrants (quality of evidence). Confidence depends on the risk of bias in the body of evidence; the precision and consistency of the results; whether the results directly apply to the patient of interest; and the likelihood of reporting bias. Shared decision making requires understanding of the estimates of magnitude of beneficial and harmful effects, and confidence in those estimates.
          Article 0 comments Cited 135 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Association between analytic strategy and estimates of treatment outcomes in meta-analyses.

            Agnès Dechartres, Douglas G. Altman, Ludovic Trinquart … (2014)
            A persistent dilemma when performing meta-analyses is whether all available trials should be included in the meta-analysis.
            Article 0 comments Cited 57 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Meta-analysis as evidence: building a better pyramid.

              Jesse Berlin, Robert M Golub (2014)
              Article 0 comments Cited 42 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Evid Based Med
                Journal ID (iso-abbrev): Evid Based Med
                Journal ID (hwp): ebmed
                Journal ID (publisher-id): ebm
                Title: Evidence-Based Medicine
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Print): 1356-5524
                ISSN (Electronic): 1473-6810
                Publication date (Print): August 2016
                Publication date (Electronic): 23 June 2016
                Volume: 21
                Issue: 4
                Pages: 125-127
                Affiliations
                Rochester, Minnesota, USA
                Author notes
                [Correspondence to ]: Dr M Hassan Murad, Evidence-based Practice Center, Mayo Clinic, Rochester, MN 55905, USA; murad.mohammad@ 123456mayo.edu
                Author information
                http://orcid.org/0000-0001-5481-696X
                Article
                Publisher ID: ebmed-2016-110401
                DOI: 10.1136/ebmed-2016-110401
                PMC ID: 4975798
                PubMed ID: 27339128
                SO-VID: 4dc6f51e-2ec4-4d30-a134-80f41a641152
                Copyright © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
                License:

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                Related
                Categories
                Subject: 1506
                Subject: Perspective
                Custom metadata
                special-feature unlocked

                Keywords: education & training (see medical education & training),epidemiology,general medicine (see internal medicine)
                Data availability:
                Keywords: education & training (see medical education & training), epidemiology, general medicine (see internal medicine)

                Comments

                Comment on this article

                scite_

                Similar content275

                See all similar

                Cited by349

                See all cited by

                Most referenced authors567

                See all reference authors