The Movement Review: Research and Evidence Based Medicine

Definition: "the integration of best research evidence with clinical expertise and patient values"

Hierarchy of Evidence:

Level 1a: Systematic Reviews of Randomized Control Trials

Comprehensive survey of a topic in which all primary studies of the highest level have been identified, analyzed and appraised
Assessed by individual reviewers
Cochrane systematic review is a type of review specifically used in health care.

Level 1b: Individual Randomized Control Trials

Type of research design in which participants are randomly split between 2 groups
One group is the intervention group, one is the control group
The control group receives either no treatment or a default treatment
Random assigning reduces risk of bias

Level 2: Cohort Study

Observational study of subjects with a specific condition and/or who are receiving a specific treatment
Followed over a period of time
Comparisons are made from the 2 groups, the cohort and possibly the gerneral population
Limitations include lack of control of variables
Not as reliable as RTC's

Level 3: Case Control Study

A study that involves identifying subjects who have the outcome of interest and control subjects without the same outcome, and looking back to see if they had an exposure of interest
Typically done retrospectively, looking back over time, example is smoking as a link to lung cancer

Level 4: Case Report or Case Series

Level 5: Expert Opinion

Other Things to Consider:

Ethical Considerations:

Informed consent, confidentiality, Protection from harm or danger, Knowledge of the outcome

Variables:

Independent Variable: the factors manipulated by the researcher
Dependent Variable: the factors used to measure the effect of the independent variable (the "effect" or outcome of interest)

Statistics:

Descriptive statistics: Summarize or describe important characteristics of a known set of data

The Movement Review