ChiroACCESS Article



Evidence-Based Practice: Method of Rating the Evidence



This information is provided to you for use in conjunction with your clinical judgment and the specific needs of the patient.

ChiroACCESS Editorial Staff

  

Parker College of Chiropractic Research Institute



Published on

May 28, 2007

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This series of reviews of the scientific literature explores wellness risk factors, diagnostic strategies and treatment options for a variety of conditions. Data was gathered from the MEDLINE, MANTIS and CINAHL databases with an effective date listed on each review as the “as of” date. A variety of search strategies were used such as “prevention AND condition”, “diagnosis AND condition”, “therapy AND condition” as well as searching the specific condition under review. The taxonomy chosen to evaluate the scientific evidence upon which this review is based is the Strength of Recommendation Taxonomy (SORT).1 This taxonomy has been adopted by the editors of the U.S. family and primary care journals. It is a patient-oriented rather than disease-oriented taxonomy and should be easily understood and utilized by primary care physicians. For the purposes of these reviews it has been modified to include an extra level of recommendation to give the reader information on interventions which have evidence of no efficacy.

Strength of Recommendation Taxonomy (SORT)

A. Recommendation based on uniform and good-quality patient-oriented studies

B. Recommendation based on conflicting or limited-quality patient-oriented studies

C. Recommendation based on guidelines, accepted practice, opinion, case series, or disease-oriented studies

D. Evidence of no efficacy based on uniform and good-quality patient-oriented studies


Definitions:

1. Good quality patient–oriented studies: Meta-analysis or systematic reviews of high quality studies or superior individual RCT’s with good follow-up.

2. Conflicting or limited-quality patient oriented studies: Meta-analysis or systematic reviews of lower quality studies with poor follow-up.
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References

1.   

Elbell MH, Siwek J, Wess BD, Woolf SH, Susman J, Ewigman B et al. Strength of recommendation taxonomy (SORT): A patient -centered approach to grading evidence in the medical literature. American Family Physician 2004; 69(3):59-67.