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Medicine: EBP Home

About this set of pages within the Medicine guide

This subset of pages will help you find evidence-based clinical resources. You can also make an appointment to see one of us, your subject specialist librarians, if you'd like some support with your research. This guide is always a work in progress, so we welcome suggestions for additional content. 

Index to sub-pages

Evidence-based healthcare (EBHC) pyramid 5.0

Evidence-based medicine resources available through the University of Otago Library, and those freely available, have been arranged here according to the Evidence-based healthcare pyramid 5.0 model proposed by Alper and Haynes. "Each of these levels should build systematically from lower levels and provide substantially more useful information for guiding clinical decision-making." (Alper & Haynes p124)

See Alper BS, Haynes RB. EBHC pyramid 5.0 for accessing preappraised evidence and guidance. Evidence-Based Medicine. 2016;21(4):123-5. Follow this link to the article  

This model proposes 5 layers of evidence sources. Using upper level sources is more likely to give you a quicker result than lower level sources.

5. Systems: decision support services that match information from individual patients with the best evidence from research that applies

4. Synthesised summaries: includes evidence-based textbooks and resources, which integrate best available evidence from the lower layers 

3. Systematically derived recommendations (Guidelines).

2. Systematic reviews: these provide a full range of evidence concerning management options for a given health problem. 

1.  Original Studies—most often examine only one aspect of management, leaving decision makers to do their own critical appraisal of the evidence.

"Within the bottom three levels, critically appraised content includes filtered (preappraised) collections of original reports, synopses of original reports (appraisal and extraction of key content), and syntheses combining multiple original reports and/or synopses." (Alper & Haynes p123)