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Prospective, randomized controlled trial
2%
45/2317
Retrospective case-control study
71%
1650/2317
Retrospective case series
16%
369/2317
Prospective cohort study
9%
217/2317
Expert opinion
1%
26/2317
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The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. Therapeutic study hierarchy of evidence has been established to better analyze studies in a reproducible fashion. Level I studies include well-designed randomized controlled prospective studies (RCT). Level II include lower quality designed prospective RCT as well as prospective cohort studies. Level III include retrospective cohort studies and case-control studies. Level IV include case series. Level V include case reports, expert opinion, and personal observation. This is summarized in illustration A. The referenced article by Brighton et al is a review of how the level of evidence has evolved and how the different levels can carry varied amounts of impact on clinical treatments and future research.
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