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6S Evidence-Based Clinical Resources

This guide is intended to help the busy clinician find the best evidence quickly using a hierarchy of content by levels of evidence.

6S Levels of Evidence

Evidence is ‘ranked’ in relation to quality when it is used to make evidence-based clinical decisions. This is often known as the evidence ‘hierarchy’, and is illustrated in the pyramid above.

The levels are in descending order of usefulness to busy clinicians. The idea is to start at the top and work your way down until you find an answer to your clinical problem, with the primary or original research at the base of the pyramid.

If every other ‘S’ level fails to provide an answer to your question it is time to look for original studies. These include randomised controlled trials (RCTs), cohort studies, case control studies, and cross sectional studies.

From: Clinical Information Access Portal (CIAP) Education Modules, eHealth NSW
http://www.ciap.health.nsw.gov.au/education/learning/module4/section_3_3.html

Based on:

DiCenso, A., Bayley, L., & Haynes, R. B. (2009). Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model. Evidence based nursing,12(4), 99-101.

http://ebn.bmj.com.ezproxy.lib.ucalgary.ca/content/12/4/99.2