3.2 Hierarchies of evidence

3.2 Hierarchies of evidence

Is all evidence equal?

Evidence-based medicine is all about using evidence to inform our clinical decision-making and practice. But what do we mean by ‘evidence’, and how do we decide what to include, and what to prioritise, in our considerations?

In their 2011 paper on levels of evidence, Burns, Rohrich and Chung describe several systems or hierarchies for the classification of evidence, taking into account factors such as the source of the evidence, study design, clarity of results and sample size. They noted that different organisations and specialities often use different frameworks, because they are asking different questions – the types of evidence considered gold standard in one specialty, might not be appropriate in another.

We will explore one framework for classifying evidence – although not one described by Burns et al – in the next step. For now however, have a think about the different types of information and evidence you might draw on to inform your clinical decisions.

Your Turn

Use Mentimeter to rank the various forms of evidence in terms of how important and reliable you believe them to be.

Once you have completed your own ranking of the different forms of evidence, you can see how other people ranked them in the next step.