Evidence-Based Medicine (EBM) is the integration of best research evidence with clinical expertise and patient values. (Sackett DL et al. Evidence-based medicine: how to practice and teach EBM. 2nd ed. Edinburgh: Churchill Livingstone, 2000).  EBM involves integration of three elements together: best clinical evidence, clinical experience and patient’s values & needs.

 

There are different levels of evidence that range from the expert opinion to the systematic reviews of randomized controlled trials: 

1a:  

Systematic reviews of RCT
1b: Individual RCT (with narrow confidence interval)
1c: All or none randomized controlled trials
2a: Systematic reviews … of cohort studies
2b:

Cohort studies or low quality randomized controlled trials (<80% follow-up)

2c:   'Outcomes' Research
3a: Systematic review … of case-control studies
3b: Individual case-control study

4:    

Case-series (poor quality cohort & case-control studies)
5:

Expert opinion without explicit critical appraisal, or

based on physiology, path physiological practices…   

Edited from UK Centre for EBM    

 

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