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
- Describes the medical history of one participant
- Used to record and alert other health care professionals to occurrences
- No control group
- Not statistically valid
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
- used to determine whether there are significant differences between groups