I agree, evidence based medicine is a movement in crisis, and indeed EBM needs to be more usable for clinicians and patients as well.
In order to serve this goal, a more comprehensive approach to EBM is needed.
Therefore I should like to point out, that in the area of occupational therapy, physiotherapy and speech and language therapy a new model for establishing the value of evidence from multiple research approaches in a systematic review was prosposed.
By separating the evidence-level criteria of internal and external validity, by incorporating explicitly the evidence provided by qualitative studies, and by retaining the critical notion of rigor, a pyramidal evidence model emerges. This model, the Research Pyramid, aligns itself with the basic modes of clinical reasoning.
The Research Pyramid should yield a superior portrayal of evidence by providing quantitative-abstract and qualitative-dense and complex information about both efficacy and effectiveness of clinical interventions.
More information about the model ist presented in the attached figure and in the following publications:
[1] Tomlin, G., & Borgetto, B. (2011). Research Pyramid: A new evidence-based practice model for occupational therapy.
American Journal of Occupational Therapy, 65, 189–196. doi: 10.5014/ajot.2011.000828
[2] Pfingsten A, Trickes C, Max S, Borgetto B. Die Forschungspyramide: Ein Modell zur Bewertung der Evidenz durch Zusammenführung verschiedener Forschungsansätze in einem systematischen Review. pt_Zeitschrift für Physiotherapeuten 2011; 63:16-8.
Competing interests:
No competing interests
01 September 2014
Bernhard Borgetto
Public Health , Professor for Health Promotion and Prevention
HAWK Hochschule für angewandte Wissenschaft und Kunst
Rapid Response:
I agree, evidence based medicine is a movement in crisis, and indeed EBM needs to be more usable for clinicians and patients as well.
In order to serve this goal, a more comprehensive approach to EBM is needed.
Therefore I should like to point out, that in the area of occupational therapy, physiotherapy and speech and language therapy a new model for establishing the value of evidence from multiple research approaches in a systematic review was prosposed.
By separating the evidence-level criteria of internal and external validity, by incorporating explicitly the evidence provided by qualitative studies, and by retaining the critical notion of rigor, a pyramidal evidence model emerges. This model, the Research Pyramid, aligns itself with the basic modes of clinical reasoning.
The Research Pyramid should yield a superior portrayal of evidence by providing quantitative-abstract and qualitative-dense and complex information about both efficacy and effectiveness of clinical interventions.
More information about the model ist presented in the attached figure and in the following publications:
[1] Tomlin, G., & Borgetto, B. (2011). Research Pyramid: A new evidence-based practice model for occupational therapy.
American Journal of Occupational Therapy, 65, 189–196. doi: 10.5014/ajot.2011.000828
[2] Pfingsten A, Trickes C, Max S, Borgetto B. Die Forschungspyramide: Ein Modell zur Bewertung der Evidenz durch Zusammenführung verschiedener Forschungsansätze in einem systematischen Review. pt_Zeitschrift für Physiotherapeuten 2011; 63:16-8.
Competing interests: No competing interests