Sample Answer 4 for NRS 445 Describe the influence “levels of evidence” have on practice changes

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Answer 3 for NRS 445 Describe the influence “levels of evidence” have on practice changes

The most reliable level of evidence in research is often represented as a pyramid, with the strongest evidence at the top and weaker evidence below. This hierarchy of evidence is based on the quality of the study, its research design, and how applicable it is to patient care. Studies with higher levels of evidence have a lower risk of bias. Clinical decisions in both human and veterinary medicine base on the best available evidence to guide their decision making to help improve patient outcomes. (Sargeant et al., 2022)

Systematic review (SR) of randomized controlled trials (RCT) is regarded as the highest levels of evidence, as they can provide a more robust and reliable conclusion than any individual study could offer. (Chen & Chi, 2023) A SR is a rigorous and thorough examination of all relevant studies on a specific topic, conducted using a systematic approach that involves a comprehensive search, selection, critical appraisal, and summary of the evidence to minimize biases and random errors. (Chen & Chi, 2023) An example is SR and meta-analysis of 16 RCTs involving 2076 patients with moderate-to-severe hidradenitis suppurativa (HS) which revealed that among 9 biologics and 3 small-molecule inhibitors which have been tested for the treatment of HS, only adalimumab and bimekizumab demonstrated significant improvement in HS clinical response without an associated increase in serious adverse events. (Chen & Chi, 2023)

Reference

Sargeant, J. M., Brennan, M. L., & O’Connor, A. M. (2022). Levels of evidence, quality assessment, and risk of bias: evaluating the internal validity of primary research. Frontiers in Veterinary Science, 9, 960957. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9315339/

Chen, Y. N., & Chi, C. C. (2023). Levels of evidence and study designs: A brief introduction to dermato-epidemiologic research methodology. Dermatologica Sinica, 41(4), 199-205. https://journals.lww.com/ders/fulltext/2023/41040/levels_of_evidence_and_study_designs__a_brief.3.aspx

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