Abstract:
Evidence based practice (EBP) was developed to assess
available scientific evidence and rank it according to the
rigour, strength and precision of the research. It aims
to provide guidance for clinicians on which to base
therapeutic decisions.1 A number of different hierarchies of
evidence have been developed to enable different types of
research to be ranked. Systematic reviews, meta analyses
and randomized controlled studies (RCTs) usually rank
highest because they provide the most reliable evidence
of treatment effects. Case reports generally rank low
on the scale, just above ideas, editorials and opinions.2
This is because they are susceptible to bias, have no
control group, and cannot be used to establish causal
relationships between the intervention and the outcome.3
However, systematic reviews and RCTs do have a number
of limitations, particularly when applied in the evaluation of
rapidly developing technologies, therapeutic devices and
procedures, or where it is legally or ethically unacceptable
to conduct such studies.
