Evidence Based Practice involves multiples levels of evidence (also known as an evidence hierarchy). The lowest level on the pyramid represents the most common or easily found evidence, while the highest level represents the least common evidence.
Image retrieved from University of Canberra Library (n.d.).
(Source: SUNY Downstate Medical Research Library of Brooklyn - Evidence-Based Medicine Course libGuide)
Some study designs are better suited to answer certain types of questions. Identifying the clinical domain your question falls under can help determine what study designs to look for in order to find the best, most suitable evidence. Systematic Reviews and Meta-Analyses are always preferred.
Check off the clinical domain and preferred study design type on the Well-Built, Patient-Oriented Clinical Question worksheet. The link to that worksheet can be found above.
|
Clinical Domain |
Preferred Study Design (after systematic reviews and meta-analyses) |
| Cost-Effectiveness | Economic Analysis |
| Diagnosis | Cross-Sectional Studies or Gold Standard |
| Etiology or Prognosis | Cohort > Case-Control > Case Series |
| Prevention | Randomized Controlled Trial > Controlled Trial > Cohort > Case-Control |
| Quality of Life | Qualitative Studies |
| Therapy | Randomized Controlled Trial > Controlled Trial or Quasi-Experimental Studies |
For example:
Clinical question: In adult patients with total hip replacements, how effective is pain medication compared to aerobic stretching in controlling post operative pain during the perioperative and recovery time?
Clinical domain: Therapy
Preferred study designs: Systematic Reviews, Meta-Analyses, Randomized Controlled Trials, and Controlled Trials
(Source: Florida State University Maguire Medical Library - PICO: Form a Focused Clinical Question libGuide)
