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Residency Research Manual: Evidence Pyramid

How Study Designs Translate into Clinical Questions

How to Read an Article

Critical appraisal is the systematic evaluation of clinical research papers in order to establish:

  1. Does this study address a clearly focused question?
  2. Did the study use valid methods to address this question?
  3. Are the valid results of this study important?
  4. Are these valid, important results applicable to my patient or population?

If the answer to any of these questions is “no”, you can save yourself the trouble of reading the rest of it.

Alll worksheets are available from the Centre for Evidence-Based Medicine, Oxford, England:

Evidence Pyramid

1. Meta Analysis, Systematic Review; 2. Randomized Control Trial, Cohort Study, Case Control Study, Case Series/Report; 3. Expert Opinion, Background Information

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Find Expert Opinions or Background Information

**Also called Teritiary Literature, it provides a broad overview of a topic but nothing new or original**

Finding Randomized Control Trials, Cohort Studies, Case Control or Case Series/Reports

**Also called Primary Literature, this is the original research that has not been interpreted or condensed by others**

Limit or filter results to Case Reports or Randomized Control Trial.

Use the MeSH database in PubMed to limit by other study designs:

Find Meta-Analysis or Systematic Review Articles

**Also called Secondary Literature, it summarizes and draws conclusions from the primary literature**

(use article filter: systematic reviews)

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