Systematic reviews

Understanding Evidence-Based Practice

The Foundation of Modern Care

Evidence-Based Practice (EBP) is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.

Best Research Evidence

Clinically relevant research from basic sciences and patient-centered clinical trials.

Clinical Expertise

Skills and experience used to identify each patient’s unique health state and diagnosis.

Patient Values

Unique preferences and expectations each patient brings to a clinical encounter.

The Hierarchy of Evidence

Reliability Index

Systematic Reviews RCT Studies Cohort Studies Case Control Case Reports Expert Opinion

Click a segment of the pyramid to evaluate its evidence strength and detailed study description.

Scientific Synthesis

A systematic review utilises a rigorous, predefined protocol to synthesise all available high-quality research on a specific clinical question.

1 Protocol

Defining PICO (Population, Intervention, Comparison, Outcome) parameters before initiation.

2 Search

Comprehensive database interrogation (PubMed, Embase) for peer-reviewed literature.

3 Quality

Applying Risk of Bias (RoB) tools to ensure only robust data informs the results.

4 Results

Unified conclusions that provide actionable guidance for clinical practice.

Strategic Impact

  • Elimination of selection bias (Cherry Picking).
  • Consolidation of disparate results into a consensus.

Statistical Pooling

Interpreting the Forest Plot

Effect Size (The Box)

The point estimate. The size of the box represents the “weight” (sample size) of that study.

Confidence Interval (The Line)

The range of uncertainty. A wider line means less precision. If the line crosses “No Effect,” the study is not significant.

Heterogeneity (I2)

Measures “scatter.” How much do studies disagree? High I2 suggests the studies are too different to combine reliably.

Active Simulation: Forest Plot

Favors Treatment NO EFFECT Favors Control
Analysis Statistics: I² = 0%

Primary vs. Secondary Research

Primary Research

Direct scientific inquiry through the collection of raw data from subjects.

  • Direct patient recruitment and observation.
  • Examples: Randomised Controlled Trials (RCTs).

Secondary Research

Filtering and analyzing existing peer-reviewed publications.

  • Integration of multiple study results.
  • Examples: Systematic Reviews & Meta-Analyses.
Feature Primary (e.g., RCT) Secondary (e.g., Systematic Review)
Scope One Specific Hypothesis Universal Consensus
Data Source Patients/Samples Peer-Reviewed Papers
Statistical Power Dependent on N Maximum Power

Scientific Authority

Providing high-fidelity educational tools to bridge the gap between complex research and clinical application.

Academic Resources

  • Cochrane Handbook
  • PRISMA Guidelines
  • GRADE Methodology

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