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Levels of quantitative research evidence are often illustrated by the evidence pyramid. There are many versions of the pyramid, but they all have filtered sources of information at the top. You may also sometimes see filtered sources referred to as synthesized sources because they synthesize single studies. You should always try to find the highest level of evidence available for your clinical question. If you do not find the highest level, move down to the next level of the pyramid until you find relevant evidence.
This version of the Evidence Pyramid (developed at Tufts University) is based in part upon the Center for Evidence-Based Medicine (CEBM) Levels of Evidence and in part upon the Evidence Based Nursing Practice tutorial by Library Faculty at Scottsdale Community College. It gives greater detail on how the domain of the question being asked impacts article selection.
Image: Evidence Pyramid
“Evidence Pyramid” by Tufts University is reused (with no changes) under the BY-NC-SA license 4.0.
The description of the sources from which the pyramid is quoted directly from Tufts University's "Selecting the Evidence" page.
The resources found in the 6S Pyramid contain evidence that will help you answer foreground questions (queries that bring together multiple concepts related to a specific clinical situation or research topic).
[Adapted from DiCenso, Bayley and Haynes (2009). ACP Journal Club. Editorial: Accessing pre-appraised evidence: Fine-tuning the 5S model into a 6S model. Annals of Internal Medicine, 151(6): JC3-2, JC3-3.]
The 6S pyramid is arranged in a hierarchy. The different levels from bottom to top are Single Studies, Synopses of Single Studies, Syntheses, Summaries, and Systems.
Use the concepts identified in your PICO or PS Question (found in the Ask tab) to come up with appropriate search terms, remembering:
This description of the 6s Model comes from McMaster University Health Sciences Library and is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The links below take you to tools to help you find the resources you need. However, some may require subscription access and others may only require an account (non-subscription based). If you come across a resource you want and cannot get it online, please contact Library staff for help.
Integrating information from the lower levels of the hiearchy with individual patient records, systems represent the ideal source of evidence for clinical decision-making.
Summaries are regularly updated clinical guidelines or textbooks that integrate evidence-based information about specific clinical problems.
Synopses of syntheses, summarize the information found in systematic reviews. By drawing conclusions from evidence at lower levels of the pyramid, these synopses often provide sufficient information to support clinical action.
Commonly referred to as a systematic review, a synthesis is a comprehensive summary of all the evidence surrounding a specific research question.
Synopses of single studies summarize evidence from high-quality studies. Evidence-based abstract journals are the best place to find this type of information.
Go to Nursing Resources on our A-Z list.
This description of the 6s Model categories with relevant links is adapted from McMaster University Health Sciences Library to address the availability of resources at Wright State. It is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copied with permission from Ximena Chrisagis at Research Guides, Wright State University:
This guide, originally created by Ximena Chrisagis at Wright State University, "was inspired by Jodi Jameson's University of Toledo DNP Evidence-Based Practice Project: Library Resources Guide. It includes video, journal, and web content developed by many external authors/creators, as well as some content by Ximena Chrisagis. Some of the external content is reused under a Creative Commons Share Alike Attribution license. When external content was not available under a Creative Commons license, it is linked rather than copied or extracted, and it is attributed to the content creator in the link name or description."
Sofia Birden of the University of Maine at Fort Kent (UMFK) changed very little of the original guide. Updates made were for format, campus-specific language, and resource links.