Hierarchy of Evidence

Hierarchy of Evidence
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Hierarchy of Evidence
The hierarchy of evidence allocates studies to different levels anchored on the methodological superiority of their validity, design, and relevance to patient care. The pyramid or hierarchy of evidence is categorized into seven levels to enable novice research readers better comprehend the distinct approaches of evidence. The seventh level entails expert opinions, editorials, anecdotes, and ideas. The sixth level entails case-controlled studies, case reports, and case series. Subsequently, cohort studies are assigned the fifth level. Random controlled trials are in the fourth level, while the critically-appraised individual articles are posted at the third level. The second level describes the critically appraised topics or evidence syntheses. Lastly, meta-analyses and systematic reviews are assigned the first level. A clear understanding of the hierarchy of evidence enables the nurse to recognize and appreciate the more reliable research levels (Ingham-Broomfield, 2016). The figure below shows the pyramid of evidence.
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