Levels of Evidence

Question 1

What is the benefit of the review process?

Answer 1

• Increased quality of science
• Increased quality of text

Question 2

Why are manuscript review processes imperfect?

Answer 2

• Varies by effort and expertise of the review team

Question 3

How long do manuscript review processes tak?

Answer 3

Years!

Question 4

Where is the submission of the manuscript in terms of being published?

Answer 4

Not close to the beginning or the end

Question 5

Assessing Journal Article Validity

Answer 5

Primary considerations (This will be scrutinized about what this applies too)
* Relevance
* Importance
* Generalizability
Subjects
* Inclusion/exclusion criteria
* How sampled?
* Sample size (power/risk of type II error)
Procedures
* Sequence of events from beginning to end
* Instruments used
* Manufacturer Information
Data Anaylsis
* Reliability/Validity
* Statistical differences and Sample Size
* Drop Outs
Study Design Purpose

Question 6

What is a systematic review?

Answer 6

• Summary of existing information on a given topic
• Ex: Effectiveness of an intervention
• Rigid criteria in order to use the best evidence to create a conclusion
• Conclusion make based on number and quality of articles for or against
• Ex: Strong, moderate, limited, conflicting evidence

Question 7

What is the PEDro Scale?

Answer 7

• Effective way to rank studies for best evidence
• Nominal categorization

Question 8

What is a Meta-Analysis?

Answer 8

• Takes results from multiple studies on a topic and combined them to get an overall average effect
• Greater emphasis place son studies with greater sample size (“weighted”)

Question 9

What is better, a systematic review or meta analysis?

Answer 9

Meta Analysis

Question 10

Evolution of “levels of evidence”

Answer 10

• First Generation: SR and MA are king
• Second Generation: Research Design Matters

Question 11

Second Generation: Levels of Evidence

Answer 11

• Lower numebrs represent “stronger evidence”
• Sackett’s level of evidence (cited in the article abstract)

Question 12

3rd Generation: Level of Evidence

Answer 12

• Why the clinical question matters

Question 13

When considering articles for application in the clinic, what do you need to consider?

Answer 13

The ability to reproduce what they did in their methods, in your clinic!

Question 14

What are randomized control trials so good?

Answer 14

They have a true control. They provide a sham treatment.