Levels of evidence

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Researching: Levels of Evidence Wellington Medical and Health Sciences Library

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What does it mean?

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A system to classify the level of scientific rigor and quality

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One common system is the Bandolier levels of evidence

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Bandolier is made up of five levels

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Where 5 is weakest…

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…and 1 is strongest

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The system ranks study designs according to their internal validity… 4

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…or degree to which they are not susceptible to bias

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What is bias?

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An influence occurring at any stage of the research process which distorts the findings

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…for example, sample bias or interview bias

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So how do different study designs rank?

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Level 1

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Level 1 Strong evidence from at least one published systematic review of multiple well-designed randomised controlled trials

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Level 2

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Level 2 Strong evidence from at least one published properly designed randomised controlled trial of appropriate size and clinical setting

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Level 3

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Level 3 Evidence from published well-designed trials without randomisation, single group pre-post, cohort, time series or matched case-controlled studies

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Level 4

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Level 4 Evidence from well-designed non-experimental studies from more than one centre or research group

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Level 5

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Level 5 Opinions of respected authorities, based on clinical evidence, descriptive studies or reports of expert consensus committees

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Or just briefly…

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Opinions based on evidence

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Non-experimental studies

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Non randomised trials…

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…or single group pre-post, cohort, time series or matched case-controlled studies

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Randomised controlled trials

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Systematic reviews

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Weakest

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Strongest

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For more, visitwww.uow.otago.ac.nz/medlibrary.html Wellington Medical and Health Sciences Library

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