Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:Introduction to Health Care and Public Health in the U.S.
Unit:Evolution of and Trends in Health Care in the U.S.
Lecture:Evidence-Based Medicine
Slide content:Hierarchy Of Evidence Literature is ranked in a hierarchy Higher on the ladder of evidence = better quality of the study Why have a hierarchy? Allows grading of studies with different methodologies Provides a framework to be used during development of systematic review protocols Method of hierarchical ordering Classify information according to effectiveness, appropriateness and feasibility 8
Slide notes:We have established some of the basic guidelines for evidence-based medicine, and now we are going to look at the medical literature, to see if we can organize it, as an evidence hierarchy. There are a number of studies that are available to clinicians on any particular subject. How does the clinician decide which study is acceptable; which study is better than another? The medical literature is ranked in a hierarchy, which helps clinicians compare studies. Think of the hierarchy as a ladder, and the higher up the ladder of evidence a study is, the better the quality of the study. A hierarchical organization allows us to rank studies according to the validity of findings. We need a hierarchy because it allows us to grade studies that have different methodologies. It provides a framework that can be used during the development of systematic review protocols to help determine which study design is better than the other. It is one method of ordering information according to effectiveness, appropriateness, and feasibility, which are all factors that the clinician is looking for when trying to interpret information with respect to patient care. 8