When we discuss levels of evidence we are generally referring to the authority and complexity of various types of medical information. From case reports, to observational studies, medicine has numerous materials that make up our collective knowledge. These item types are often ranked using numbers or a hierarchical pyramid. Generally, the top of the pyramid are Systematic reviews, one of the most complex types of review. Use the tools below to familiarize yourself with the various types of medical information and how to use it.
This video from Univ. of Louisville Libraries explains what the levels of evidence are, the difference between primary and secondary sources, and the different types of reviews. 8 minutes.
Quantitative studies generate numerical data, or data that can be converted into numbers, to learn how many, how much, how often. Quantitative studies are often easier to locate, as the type of study usually appears in the title, and medical databases have built in filters to locate quantitative materials. Look for the following terms to signal a quantitative study, and make sure you familiarize yourself with the differences in study types and where they fall in the levels of evidence.
Case series and Case reports consist of collections of reports on the treatment of individual patients or a report on a single patient. Because they are reports of cases and use no control groups to compare outcomes, they have little statistical validity.
You can also use the filters in CINAHL (under Filters and Publication Type) and PubMed (on the left after search titled, Article Type). Engaging any of these filters will limit your results to just that type of study or material.
Qualitative studies use non-numeric data to understand the why and how of people's beliefs, experiences, attitudes, behavior and interactions. You will often see the following terms/titles used:
For MEDLINE/Pubmed recall this database uses what are called subject terms, labeled MeSH.
In PubMed, you can use "Qualitative Research" or "Nursing Methodology Research" as a SUBJECT term. You can copy and paste this search string into the Pubmed search box along with your other keywords for your search connecting it with AND:
qualitative research [MeSH] OR qualitative[tiab]
You can also use the filters in PubMed, on the left after search titled, Article Type. Engaging any of these filters will limit your results to just that type of study or material.
CINAHL uses the CINAHL heading "Qualitative Studies" complemented by more detailed terms, including "Phenomenological Research" and "Focus Group," etc. You can use any of the Filters under the Advanced Search as well, and limit to the item type you want.
For any database you can add the following search string to your other keywords preceded by the word "AND."
(qualitative OR ethnograph* OR phenomenol* OR ethnonurs* OR grounded theor* OR “purposive sample” OR hermeneutic* OR heuristic* OR semiotics OR lived experience* OR narrative* OR “life experiences” OR “cluster sample” OR “action research” OR “observational method” OR “content analysis” OR “thematic analysis” OR “constant comparative method” OR field stud* OR “theoretical sample” OR “discourse analysis” OR focus group* OR “ethnological research” OR ethnomethodolog* OR interview*)
Here are links to resources on the different types of reviews and how to read and write them.