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The Hierarchy of Evidence: From Unsystematic Clinical Observations to Systematic Reviews

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Neurology

Abstract

A key principle of evidence-based medicine is the recognition that not all evidence is similarly protected against error, and that decisions that rely on evidence would be more confident when the evidence is more protected against bias by virtue of the methods used. Thus, a fundamental principle of evidence-based medicine is the recognition of a hierarchy of evidence. A review of the different approaches the scientific method has evolved to protect evidence from bias is presented as well as the evolution of how methodologists have built hierarchies of evidence and note the limitations and merits of these approaches.

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Author information

Authors and Affiliations

  1. Knowledge and Evaluation Research Unit, Department of Medicine, Division of Endocrinology, Mayo Clinic, Rochester, MN, USA

    Mohamed B. Elamin MBBS & Victor M. Montori MD, MSc

Authors
  1. Mohamed B. Elamin MBBS
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  2. Victor M. Montori MD, MSc
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Corresponding author

Correspondence to Victor M. Montori MD, MSc .

Editor information

Editors and Affiliations

  1. London Health Sciences Centre, Dept. Clinical Neurosciences, University of Western Ontario, Windermere Road 339, London, N6A 5A5, Ontario, Canada

    Jorge G. Burneo

  2. , Neurology, Mayo Clinic Hospital, E. Mayo Blvd. 5777, Phoenix, 85054, Arizona, USA

    Bart M. Demaerschalk

  3. London Health Sciences Centre, Dept. Clinical Neurosciences, University of Western Ontario, Windermere Road 339, London, N6A 5A5, Ontario, Canada

    Mary E. Jenkins

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© 2012 Springer Science+Business Media, LLC

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Elamin, M.B., Montori, V.M. (2012). The Hierarchy of Evidence: From Unsystematic Clinical Observations to Systematic Reviews. In: Burneo, J., Demaerschalk, B., Jenkins, M. (eds) Neurology. Springer, New York, NY. https://doi.org/10.1007/978-0-387-88555-1_2

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  • DOI: https://doi.org/10.1007/978-0-387-88555-1_2

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-88554-4

  • Online ISBN: 978-0-387-88555-1

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