Level 1: (higher quality of evidence) – High quality randomized trial or prospective study; testing of previously developed diagnostic criteria on consecutive patients; sensible costs and alternatives; values obtained from many studies with multiway sensitivity analyses; systematic review of Level I RCTs and Level I studies.
Basically, level 1 and level 2 are filtered information – that means, an author has gathered evidence from well-designed studies, with credible results, and has produced findings and conclusions appraised by renowned experts, who consider them valid and strong enough to serve researchers and scientists.
This kind of research is key to learn about a medicine’s effectiveness. Cohort studies: A longitudinal study design, in which one or more samples called cohorts (individuals sharing a defining characteristic, like a disease) are exposed to an event and monitored prospectively and evaluated in predefined time intervals.
When carrying out a project you might have noticed that while searching for information, there seems to different levels of credibility given to different types of scientific results. For example, it is not the same to use a systematic review or an expert opinion to base an argument.
Level 1: (higher quality of evidence) – High quality randomized trial or prospective study ; testing of previously developed diagnostic criteria on consecutive patients; sensible costs and alternatives; values obtained from many studies with multiway sensitivity analyses; systematic review of Level I RCTs and Level I studies.
When carrying out a project you might have noticed that while searching for information, there seems to different levels of credibility given to different types of scientific results. For example, it is not the same to use a systematic review or an expert opinion to base an argument. It’s almost common sense that the first will demonstrate more accurate results than the latter, which information ultimately derives from a personal opinion.
Level 2: Lesser quality RCT; prospective comparative study; retrospective study; untreated controls from an RCT; lesser quality prospective study; development of diagnostic criteria on consecutive patients; sensible costs and alternatives; values obtained from limited stud- ies; with multiway sensitivity analyses; systematic review of Level II studies or Level I studies with inconsistent results.
When drafting a systematic review, authors are expected to deliver a critical assessment and evaluation of all this literature rather than a simple list. Researchers that produce systematic reviews have their own criteria to locate, assemble a evaluate a body of literature.
Basically, level 1 and level 2 are filtered information – that means, an author has gathered evidence from well-designed studies, with credible results, and has produced findings and conclusions appraised by renowned experts, who consider them valid and strong enough to serve researchers and scientists. Level 3, 4 and 5 include evidence coming from unfiltered information. Because this evidence hasn’t been appraised by experts, it might be questionable, but not necessarily false or wrong.
Randomized Controlled Trial: a clinical trial in which participants or subjects (people that agree participating in the trial) are randomly divided in groups. Placebo (control) is given to one of the groups whereas the other is treated with medication. This kind of research is key to learn about a medicine’s effectiveness.
With the increasing need from physicians (but also scientists of different fields of study) to know what kind of research they can expect the best clinical evidence, experts ranked this evidence to help them identify the best sources of information to answer their questions. The criteria for ranking evidence is based on design, methodology, validity and applicability of the different types of studies. The outcome is called “levels of evidence” or “levels of evidence hierarchy”. By organizing a well-defined hierarchy of evidence, academia experts were aiming to help scientists feel confident in using findings from high-ranked evidence in their own work or practice. For Physicians, whose daily activity depends on available clinical evidence to support decision-making, this really helps them to know which evidence to trust the most.