Pyramid of evidence

Classifying the evidence from clinical trials – the need to consider other dimensions

The current approach to assessing the quality of evidenceobtained from clinical trials focuses on three dimensions: thequality of the design (with double-blinded randomised controlledtrials representing the highest level of such design); the statisticalpower (beta) and the level of significance (alpha). While theseaspects are important, we argue that other significant aspects oftrial quality impinge upon the truthfulness of the findings: biologicalplausibility, reproducibility and generalisability.

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Resource quality according to evaluation criteria, range 0-32: 25