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Evidence-Based Medicine Tutorials

Guide Attribution

This guide page is a derivative of the EBM Resource Pyramid Guide by the Health Sciences Library System at the University of Pittsburgh. It is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International LicenseCC BY-NC-SA

Evidence-Based Medicine Resources

Evidence-Based Medicine is the integration of best research evidence with clinical expertise and patient values. (Sackett DL, Straus SE, Richardson WS, et al. Evidence-based medicine: how to practice and teach EBM. 2nd ed. Edinburgh: Churchill Livingstone, 2000.)

EBM Resource Pyramid. For a text-based version, see text below image.

EBM Pyramid and EBM Page Generator, copyright 2006 Trustees of Dartmouth College and Yale University. All Rights Reserved. Produced by Jan Glover, David Izzo, Karen Odato and Lei Wang. EBM Resource Pyramid.

The Evidence-Based Pyramid depicts a triangular representation of the levels of evidence with the strongest evidence at the top and progressing down through evidence with decreasing strength. At the apex of the pyramid are Systematic Reviews, which are the strongest form of evidence. Under them are lesser strength formats for filtered information including Critically-Appraised Topics (Evidence Synthesis) and Critically-Appraised Individual Articles (Article Synopses). Below that is unfiltered information, the top form being Randomized Controlled Trials. Successive lower levels include Cohort Studies, Case-Controlled Studies, Case Reports and Background Information/Expert Opinion.

Filtered resources appraise the quality of studies and often make recommendations for practice.

Systematic Reviews / Meta-Analyses

Authors of a systematic review ask a specific clinical question, perform a comprehensive literature search, eliminate the poorly done studies and attempt to make practice recommendations based on the well-done studies. A meta-analysis is a systematic review that combines all the results of all the studies into a single statistical analysis of results.

Clinical Study Categories and Medical Genetics topics can be specified in PubMed, and Systematic Reviews are also searchable in MEDLINE.


Do a PubMed search and limit to the subset "Systematic Review."

Authors of critically-appraised topics evaluate and synthesize multiple research studies, and authors of critically-appraised individual articles evaluate and synopsize individual research studies.


Evidence is not always available via filtered resources. Searching the primary literature may be required. It is possible to use specific search strategies in MEDLINE and other databases to achieve the highest possible level of evidence.

Topic-Specific PubMed Queries


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Except where otherwise noted, content in these research guides is licensed under a Creative Commons Attribution 4.0 International License. Creative Commons Attribution License