The levels of evidence in research and practice explain the evidential strength of different research designs. High levels of evidence are usually a characteristic of studies with the high degree of quantitative analysis, highest internal validity, and are based on stringent scientific methodology and data analysis (Dang & Dearholt, 2017). The evidence is usually scaled in a top-down hierarchy, in which the stronger evidence is higher in the hierarchy. The levels vary and are usually assigned different alphanumeric or roman numbers. According to DiCenso, Guyatt, and Ciliska’s Nursing Guidebook (2014), The level of evidence takes into account the type of study; these include:
Level 1: This level includes studies such as systematic reviews, metanalysis, and Randomized Controlled Trials. These form the basis for the strongest research and practice evidence. The studies exert more control over their methodologies, thereby limiting the chance of error in their results.
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Level 2: These are evidence derived from quasi-experimental studies or systematic reviews of RCT with homogeneity.
Level 3: Evidence derived from non-experimental studies or controlled trials without randomization.
Level 4: Evidence derived from cohort or well-designed case-control studies.
Level 5: Evidence derived from qualitative studies or single descriptive studies.
Level 6: This evidence is often based on the opinion of recognized experts, consensus panels, or revered authorities in the discipline. This evidence may also include clinical practice guidelines.
Level 7: This evidence may be based on non-research or experimental studies. These sources include case reports, program evaluation, and quality improvement, and literature reviews.
The levels of evidence are important in evaluating the quality of the methodology and statistical analysis used in the process of obtaining research data and results (Dang, & Dearholt, 2017). Levels of evidence are also important in practice as they as used to evaluate the etiology, pathophysiology, diagnosis, prognosis, and, complications associated with a certain condition or infection. They also provide a platform for assessing the quality of treatment. It should, however, be noted that different procedures, e.g., diagnosis and prognosis may have different levels of evidence ( DiCenso, Guyatt, and Ciliska, 2014). A high level of evidence for a diagnosis study may not correlate to a high level of evidence for a treatment study.
References
Dang, D., & Dearholt, S. L. (2017). Johns Hopkins nursing evidence-based practice: Model and guidelines . Sigma Theta Tau.
DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Evidence-Based Nursing-E-Book: A Guide to Clinical Practice . Elsevier Health Sciences.
