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TABLE 7-2 Hierarchy of Evidence for Different Types of Clini

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Principles and Practice of Hospital Medicine, 2e > Principles of EvidenceBased Medicine and Quality of Evidence
Sylvia C. McKean, John J. Ross, Daniel D. Dressler, Danielle B. Scheurer+
TABLE 7-2Hierarchy of Evidence for Different Types of Clinical Questions
Type of Clinical Question
Best Types of Articles (Listed in Decreasing Level of Evidence)
Therapy or harm
1. Systematic review/meta-analysis of randomized controlled trials
2. Randomized controlled trial
3. Cohort study
4. Case-control study
5. Case series
6. Case reports
7. Expert opinion
Accuracy of a diagnostic test
1. Systematic review/meta-analysis
2. Prospective comparison against gold standard conducted in setting diagnostic test will be used in
practice
Prognosis
1. Systematic review/meta-analysis
2. Prospective cohort study of a representative, homologous patient group with appropriate follow-up
and objective outcomes.
3. Retrospective case-controlled study
Differential diagnosis of a condition
1. Systematic review/meta-analysis
2. Prospective evaluation of a representative sample that includes definitive diagnostic evaluation,
performed in a setting similar to actual practice
Date of download: 05/03/19 from AccessMedicine: accessmedicine.mhmedical.com, Copyright © McGraw-Hill Education. All rights reserved.
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