HIERARCHY OF EVIDENCE An approach to assessing the reliability and evidence based nature of information - from John Lee, MD Listed in descending order of most evidence based information A: Guidelines (caution-some guidelines are not evidence based) 1)Gov Clearinghouse Web Site 2)Grateful Med-search with "Guideline" as publication type 3)MD Consult Guidelines 4)Community Standards-i.e. Sutter Handbook of Best Practices 5)Consensus Conferences: AHCPR, NIH B: Respected Organizations 1)Cochrane Collaboration - systematic meta-analysis 2) American College of Physicians (ACP) - Best Evidence - Searchable CD-ROM. Available in CD tower in library - accessable through LAN 3) Group Health - CD 4) Inforetriever - CD 5)US Preventive Service Task Force C: Critical Review 1) Journal of Family Practice (web infopoems) 2)Bandolier 3) Gorll with quarterly update of text on CD 4) Yearbook - MDConsult D: Meta-analysis - Medline E: Articles 1) Randomized Controlled Trials 2) Reviews F: Textbook 1) Primary Care Medicine, Goroll has quarterly CD Rom updates. 12 new chapters per quarter. Available in CD tower 2) Essentials of Family Medicine, Sloan 3) Scientific American G: Expert Opinion CCRMC Look-up in Medi-tech (Intra-net in future) H: Anecdotal Experience -preceptor, experienced staff
Martinez Marisha Lockwood UC Davis -Chilcott Gabriel Mayland Finch U/Chicago Med School Nancy Palmer UC San Francisco Jessica Roberts UC San Francisco Felicia Tomabene UC San Diego Christiana Weng Baylor
Richmond Kwan Chun Ohio State Tara Lehman UC San Diego
Pittsburg Sarah Lamanuzzi UC San Diego James Pehling UC San Francisco