CLINICAL EVIDENCE:WHY AND HOW TO GENERATE IT

Muhammad Saaiq,Department of Medical Education,

PIMS, Islamabad.

What Constitutes Evidenceand

Evidence based medicine (EBM)

1 a Evidence obtained from Meta analysis of RCTs.

1 b Evidence obtained from at least one individual RCT.

1 c Evidence obtained from all on none case-series.

2 a Evidence obtained from Systematic Review of Cohort studies.

2 b Evidence obtained from a single cohort or a poor RCT.

2 c Outcomes research ecological studies.

3 a Systematic Review of Case controlled studies.

3 b Individual case controlled study.

4 Case series. ( including poor quality cohorts and case controls)5 Evidence obtained from expert committee reports or opinions and /

or clinical experiences of respected authorities without explicit critical appraisal.

Hierarchy of Evidence

CAP

SR

CAT

Paradigm Shift

ObservationalExperimental

Clinical Research

Clinical Research

Observational Experimental

Controlled Trials

Non-Controlled Trials

Case Series

Cross Sectional

Case Controls

Cohorts

Case Series Studies

Cross Sectional Studies

Cohorts and Case Control Studies

Clinical Trials/ Experimental Research

Systematic Reviews and Meta Analysis

No Research Without “Search”

CONCLUSION&

MESSAGE

Thank YouThank You