Evidence Based Practice (EBP)

The strongest evidence for clinical decision-making is found at the top of the evidence pyramid: secondary literature such as systematic reviews, meta-analyses, evidence summaries and practice guideline. Evidence gets weaker the further down the pyramid you go.

Source: The Logic of Science       License:  https://creativecommons.org/licenses/by-sa/4.0/deed.en

Steps To finding the highest level evidence:

1. Begin with a well-formulated clinical question. See PICO.

2. Conduct a search for secondary literature using the library's RESEARCH TOOLS.

• Pre-Appraised sources such as NNT and Cochrane save time -they evaluate the quality of systematic reviews and synthesize the evidence for you.
• Article databases such as PubMed provide access to systematic reviews without appraisal. See PUBMED STRATEGIES for tips on finding evidence.

3. If you are unable to find evidence in the secondary literature, move down the pyramid and conduct a search for original studies in the primary literature.  

NOTE: High levels of evidence may not be available for all clinical questions, due to medical or ethical limits. Systematic reviews aren't the most current, since it can take at least six months to conduct a quality review.