Evidence-Based Practice: A Pyramid of Evidence

Summary

In this module by Michael Paris, Health Sciences librarian at University of the Pacific, the focus is on the Evidence-Based Practice (EBP) Pyramid. The session educates on different levels of evidence, distinguishing between filtered and unfiltered evidence, and evaluates website quality using the Pyramid of Evidence. The module emphasizes the importance of scrutinizing information rigor and authority, guiding viewers to identify the best evidence for clinical and educational decision-making.

Takeaways

• 📚 The module is about the Evidence-Based Practice (EBP) pyramid, focusing on levels of evidence in healthcare.
• 🔍 By the end, participants will be able to investigate six major types of evidence and differentiate between filtered and unfiltered evidence.
• 🏥 The pyramid of evidence, created by Andy Pirro, helps assess the quality of information from various sources.
• 📈 Evidence types are ranked from the least to the most rigorous, starting with background information and expert opinion at the bottom.
• 👨‍⚕️ Case reports and case series provide detailed, individual patient information but are considered lower in the evidence hierarchy.
• 👥 Cohort and case-control studies are observational studies that look at groups of people over time or in response to an event.
• 🧬 Randomized Controlled Trials (RCTs) are considered the gold standard in clinical trials, minimizing bias by randomly assigning subjects to treatment or control groups.
• 📑 Critically Appraised Topics (CATs) offer concise summaries of evidence on a specific clinical question.
• 📋 Clinical practice guidelines are recommendations informed by systematic reviews to optimize patient care.
• 🔍 Systematic reviews provide a transparent and repeatable process for considering all published evidence on a specific clinical question.
• 📊 Meta-analyses use quantitative methods to summarize results from multiple studies, often appearing at the top of the evidence pyramid.

Q & A

What is the main focus of the EBP pyramid of evidence module?

The main focus of the EBP pyramid of evidence module is to study the levels of evidence in the pyramid, differentiate between filtered and unfiltered evidence, and evaluate websites using the Pyramid of Evidence to assess the quality of information within those websites.

Who created the levels of evidence pyramid?

The levels of evidence pyramid was created by Andy Pirro, who is located at gwu imlfarb Health Science Library.

What is the purpose of evaluating websites using the Pyramid of Evidence?

The purpose of evaluating websites using the Pyramid of Evidence is to assess the quality of information within those websites, ensuring the information is rigorous and authoritative.

What is considered the bottom level of the evidence pyramid?

The bottom level of the evidence pyramid consists of background information and expert opinion, which can be found in textbooks, websites, or blogs.

What is a case report and where does it fit in the evidence pyramid?

A case report is a detailed report of an individual patient's symptoms, signs, diagnosis, treatments, and follow-ups. It is considered a major type of evidence and is placed above background information and expert opinion in the pyramid.

What does RCT stand for and why is it significant?

RCT stands for Randomized Controlled Trials, which are significant because they are the gold standard for clinical trials as they assess a variable such as a drug or treatment with subjects randomly assigned to treatment or control groups to minimize bias.

What are CATs in the context of evidence-based practice?

CATs, or Critically Appraised Topics, are short summaries of the evidence on a topic of interest, usually focused around a clinical question. They are a shorter and less rigorous version of a systematic review.

What is the role of clinical practice guidelines in the evidence pyramid?

Clinical practice guidelines are recommendations intended to optimize patient care, informed by systematic review of the evidence, and they assess the benefits and harms of alternative options.

Why are systematic reviews considered the gold standard in evidence-based decision making?

Systematic reviews are considered the gold standard because they provide a transparent and repeatable process that considers all published evidence, not just selected studies, allowing for a comprehensive summary of findings from research on a particular topic.

What is the difference between filtered and unfiltered information in the evidence pyramid?

Filtered information, found at the top of the pyramid, has been analyzed and summarized by other researchers, such as in CATs, systematic reviews, and meta-analyses. Unfiltered information, in the middle of the pyramid, includes original research like experiments, trials, cohort studies, case-control studies, and case reports, which have not been filtered through other sources.

What is the role of TRIP database in evidence-based practice?

The TRIP database is a meta search engine that searches for information and filters it to find evidence-based answers. It allows users to filter for filtered or unfiltered information, as well as specific types of studies like meta-analyses, systematic reviews, or cohort studies.