CLINICAL EVIDENCE:

WHY AND HOW TO GENERATE IT

Muhammad Saaiq,
Department of Medical Education,
PIMS, Islamabad.
 What Constitutes Evidence
and
Evidence based medicine (EBM)
 Hierarchy of Evidence
1 a Evidence obtained from Meta analysis of RCTs.
1 b Evidence obtained from at least one individual RCT.
1 c Evidence obtained from all on none case-series.
2 a Evidence obtained from Systematic Review of Cohort studies.
2 b Evidence obtained from a single cohort or a poor RCT.
2 c Outcomes research ecological studies.
3 a Systematic Review of Case controlled studies.
3 b Individual case controlled study.
4 Case series. ( including poor quality cohorts and case controls)
5 Evidence obtained from expert committee reports or opinions and /
or clinical experiences of respected authorities without explicit
critical appraisal.
SR

CAT
CAP
Paradigm Shift
Clinical Research

y Observational
y Experimental
 Clinical Research

Observational Experimental

Case Series
Controlled Trials

Cross Sectional

Non-Controlled Trials

Case Controls

Cohorts
Case Series Studies
Cross Sectional Studies
Cohorts and Case Control Studies
Clinical Trials/ Experimental Research
Systematic Reviews and Meta Analysis
No Research Without “Search”
CONCLUSION
&
MESSAGE
Thank You