Appraising the evidence

There are two criteria:  The level of evidence and utility.

The level of evidence (*1)

The level of evidence is the ability of the evidence to reliably predict cause-effect.
Evidence Level (level 1 trumps level 2; level 2 trumps level 3; etc.)

 Evidence Level Study Type
1 Systematic review of randomized controlled trials and randomized controlled trials
2 Systematic review of cohort trials, and cohort trials
3 Systematic review of case-control trials, and case-control trials
4 Case series
5 Narrative review
Not Applicable Case report, epidemiology, animal studies, in vitro studies

Clinical utility (*2)

Clinical utility is based on:

  • Validity (freedom from bias)
  • Clinical importance (difference between experimental and control group)
  • Clinical relevance (importance to patients one treats)

* References

  1. Levels of evidence and grades of recommendation. Centre for Evidence-Based Medicine, Oxford.
  2. Critical appraisal tools. Critical Appraisal Skills Program, Oxford.