To understand and assess levels of evidence, it's helpful to have an understanding of the basic characteristics of the major evidence types, several of which are defined below. For additional evidence type definitions browse the Center for Evidence-Based Medicine Glossary Systematic Review The application of strategies that limit bias in the assembly, critical appraisal, and synthesis of all relevant studies on a specific topic. Systematic reviews focus on peer-reviewed publications about a specific health problem and use rigorous, standardized methods for selecting and assessing articles. A systematic review may or may not include a meta-analysis, which is a quantitative summary of the results. Randomized Controlled Trial An experiment in which subjects in a population are randomly allocated into groups, usually called study and control groups, to receive or not receive an experimental preventive or therapeutic procedure, maneuver, or intervention. The results are assessed by rigorous comparison of rates of disease, death, recovery, or other appropriate outcomes in the study and control groups. Cohort Studies Cohort studies identify a group of patients who are already taking a particular treatment or have an exposure, follow them forward over time, and then compare their outcomes with a similar group that has not been affected by the treatment or exposure being studied. Cohort studies are observational and not as reliable as randomized controlled studies since the two groups may differ in ways other than in the variable under study. Case-Control Studies Case-control studies are studies in which patients who already have a specific condition are compared with people who do not have the condition. The researcher looks back to identify factors or exposures that might be associated with the illness. They often rely on medical records and patient recall for data collection. These types of studies are often less reliable than randomized controlled trials and cohort studies because showing a statistical relationship does not mean that one factor necessarily caused the other. Cross-Sectional Studies Describe the relationship between diseases and other factors at one point in time in a defined population. Cross-sectional studies lack any information on the timing of exposure and outcome relationships and include only prevalent cases. They are often used for comparing diagnostic tests. Studies that show the efficacy of a diagnostic test are also called prospective, blind comparisons to a gold standard study. This is a controlled trial that looks at patients with varying degrees of an illness and administers both diagnostic tests — the test under investigation and the “gold standard” test — to all of the patients in the study group. The sensitivity and specificity of the new test are compared to that of the gold standard to determine potential usefulness. Case Series and Case Reports Case series and Case reports consist of collections of reports on the treatment of individual patients or a report on a single patient. Because they are reports of cases and use no control groups to compare outcomes, they have little statistical validity. Definitions adapted from: https://www.cebm.ox.ac.uk/resources/ebm-tools/glossary
Internet Citation: 5. Improving Data Collection across the Health Care System. Content last reviewed May 2018. Agency for Healthcare Research and Quality, Rockville, MD.
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