Evidence-Based Medicine Paper

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Evidence-Based Medicine Paper

What levels of evidence are present in relation to research and practice, and why are they important regardless of the method you use?

Evidence-based medicine (EBM) helps in clinical decision-making for the benefit of patients. One major component of EBM is the system of hierarchy for evidence classification. The name of this hierarchy is popularly referred to as the levels of evidence. For answering clinical questions, physicians need to use the highest level of evidence available. Various levels of evidence have been developed over the years but here are some common ones used.Evidence-Based Medicine Paper


The evidence levels for Prognostic

Level Type of evidence
I High quality prospective cohort studies
A systemic review of the above studies

II Cohort studies of a lesser quality, retrospective cohort studies, untreated controls from an RCT, and a systematic review of the above studies.
III Case control studies
A systematic review of case control studies

IV Case series
V Case reports, expert opinions, bench research, evidence-based physiology, ‘first principles’
(Burns, Rohrich, & Chung, 2011)

For therapeutic studies

Level Type of evidence
1A Systematic review of RCTs (With homogeneity)
1B Individual RCT
1C None or all study
2A Systematic review of cohort studies (With homogeneity)
2B Individual cohort studies
2C Ecological studies
Outcomes research

3A Systemic review of case-control studies (With homogeneity)
3B Individual case-control studies
4 Case series
Poor quality case control and cohort studies

5 Expert opinion
(Burns, Rohrich, & Chung, 2011)

When referring to levels of evidence, priority is given to level 1 evidences and it reduces as one goes down the hierarchy. Referring to levels of evidence is important because it improves the quality of decision-making.Evidence-Based Medicine Paper


Burns, P. B., Rohrich, R. J., & Chung, K. C. (2011). The levels of evidence and their role in evidence-based medicine. Plastic and reconstructive surgery, 128(1), 305–310. https://doi.org/10.1097/PRS.0b013e318219c171

Evidence-Based Medicine Paper