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OVID MEDLINE

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The 6S levels of organization of evidence from
health care research
by R Brain Haynes, 2009
Computer
Summaries
Synopses of Syntheses
Syntheses
ACP Journal Club
Synopses of studies
Studies
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MEDLINE

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Title FRAX or fiction determining optimal screening strategies for treatment of osteoporosis in residents in long-term care facilities.
???Osteoprosis Diphosphonates
Cross-Sectional Studies
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Diagnosis
Osteoprosis
Drug therapy
Epidemiology
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?????? ( A taxonomy of clinical research)
by David A Grimes, Kenneth F Schulz,2002
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• Therapy/Prevention??/?????
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• Prognosis??
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Oxford Centre for Evidence-based Medicine Levels
of Evidence (May 2001)
Level Therapy/Prevention, Aetiology/Harm Prognosis Diagnosis Differential diagnosis/symptom prevalence study Economic and decision analyses
1a SR (with homogeneity) of RCTs SR (with homogeneity) of inception cohort studies CDR validated in different populations SR (with homogeneity) of Level 1 diagnostic studies CDR with 1b studies from different clinical centres SR (with homogeneity) of prospective cohort studies SR (with homogeneity) of Level 1 economic studies
1b Individual RCT (with narrow Confidence Interval) Individual inception cohort study with gt 80 follow-up CDR validated in a single population Validating cohort study with good reference standards or CDR tested within one clinical centre Prospective cohort study with good follow-up Analysis based on clinically sensible costs or alternatives systematic review(s) of the evidence and including multi-way sensitivity analyses
1c All or none All or none case-series Absolute SpPins and SnNouts All or none case-series Absolute better-value or worse-value analyses
2a SR (with homogeneity) of cohort studies SR (with homogeneity) of either retrospective cohort studies or untreated control groups in RCTs SR (with homogeneity) of Level gt2 diagnostic studies SR (with homogeneity) of 2b and better studies SR (with homogeneity) of Level gt2 economic studies
2b Individual cohort study (including low quality RCT e.g., lt80 follow-up) Retrospective cohort study or follow-up of untreated control patients in an RCT Derivation of CDR or validated on split-sample only Exploratory cohort study with goodreference standards CDR after derivation, or validated only on split-sample or databases Retrospective cohort study, or poor follow-up Analysis based on clinically sensible costs or alternatives limited review(s) of the evidence, or single studies and including multi-way sensitivity analyses
2c "Outcomes" Research Ecological studies "Outcomes" Research   Ecological studies Audit or outcomes research
3a SR (with homogeneity) of case-control studies   SR (with homogeneity) of 3b and better studies SR (with homogeneity) of 3b and better studies SR (with homogeneity) of 3b and better studies
3b Individual Case-Control Study   Non-consecutive study or without consistently applied reference standards Non-consecutive cohort study, or very limited population Analysis based on limited alternatives or costs, poor quality estimates of data, but including sensitivity analyses incorporating clinically sensible variations.
4 Case-series (and poor quality cohort and case-control studies) Case-series (and poor quality prognostic cohort studies) Case-control study, poor or non-independent reference standard Case-series or superseded reference standards Analysis with no sensitivity analysis
5 Expert opinion without explicit critical appraisal, or based on physiology, bench research or "first principles" Expert opinion without explicit critical appraisal, or based on physiology, bench research or "first principles" Expert opinion without explicit critical appraisal, or based on physiology, bench research or "first principles" Expert opinion without explicit critical appraisal, or based on physiology, bench research or "first principles" Expert opinion without explicit critical appraisal, or based on economic theory or "first principles"
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Which therapy have more benefit for Atopic
Dermatitis either Tacrolimus or
Corticosteroids.
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?????Primary Term ?MeSH Term ???1 ???2
P ( Atopic Dermatitis with children or eczema atopic or eczema infantile ) and
I ( Tacrolimus or fk 506 or Protopic ) and
C ( Corticosteroids or adrenal cortex hormones or corticoids ) and
O ( quality of life or or )
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MEDLINE ????????
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MeSH
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