Skip to main content

Advertisement

Table 5 Evidence Threshold Pathway Mapping

From: Hierarchies of evidence applied to lifestyle Medicine (HEALM): introduction of a strength-of-evidence approach based on a methodological systematic review

Is the question definitively addressable with RCTs?1
YES if: The outcome of interest would be measurable in < 5 years, subjects can ethically be randomized, a control group is plausible and ethical, blinding is potentially possible, a sample size of < 10,000 would provide adequate statistical power
If YES, have RCTs been conducted?
 ➔(1) If YES, then use GRADE2
 ➔(2) If NO, then use an alternative tool, consider OCEBM3
NO if: A duration > 5 years adherence to the intervention is required, randomization is not plausible or ethical, exposure of interest is the cumulative, lifetime effect of health behaviors.
 ➔ (3) Consider HEALM4
  1. 1 RCTs: randomized controlled trials
  2. 2 GRADE: Grading of Recommendations, Assessment, Development and Evaluation;
  3. 3 HEALM: Hierarchies of Evidence Applied to Lifestyle Medicine
  4. 4 OCEBM: Oxford Center for Evidence Based Medicine