scholarly journals Definition of Levels of Evidence (LoE) and Overall Strength of Evidence (SoE)

2014 ◽  
Vol 05 (02) ◽  
pp. 166-166 ◽  
Keyword(s):  
Strength Of Evidence ◽  
Levels Of Evidence ◽  
Definition Of

scholarly journals Levels of evidence backing the AAOS clinical practice guidelines

2021 ◽  
pp. 221049172199253
Author(s):  
Arjun K Reddy ◽  
Jared Scott ◽  
Jake X Checketts ◽  
Keith Fishbeck ◽  
Marshall Boose ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Postoperative Treatment ◽  
Anatomical Site ◽  
Supporting Evidence ◽  
Anatomic Site ◽  
Level Of Evidence ◽  
Strength Of Evidence ◽  
Levels Of Evidence

Purpose: The American Academy of Orthopaedic Surgeons produces clinical practice guidelines for the treatment of orthopedic injuries. We examined the strength of the evidence underlying these recommendations in order to answer the following questions: (1) Have AAOS work groups improved guideline creation practices to locate evidence to generate strong recommendations? (2) Is there variability in the available evidence based on anatomic site or stage of care? (3) Has the level of evidence supporting improved over time? Methods: Twenty-two current guidelines of the Academy were examined which yielded 408 individual recommendations. These recommendations were assigned one of five strength of evidence ratings (strong, moderate, limited, inconclusive, consensus) by the guideline panel, based on the availability and quality of the supporting evidence. From these guidelines, we extracted all of the recommendations and their corresponding evidence ratings. We then classified the recommendations by stage of care, year, and anatomical site. Results: The distribution of the levels of evidence was as follows: 77 (18.9%) were based on consensus; 53 (13.0%) were inconclusive; 93 (22.8%) were based on limited evidence; 112 (27.5%) were based on moderate evidence; and 73 were based on (17.9%) strong evidence. Strong strength of evidence was found in 45.2% of the recommendations for preventive/screening/diagnostic care, 41.1% of nonsurgical treatment, 45.1% of surgical treatment, 51.1% of rehabilitation/postoperative treatment, and 45.5% of the recommendations that had mixed stages of care. Inconclusive strength of evidence was found to be prevalent from 2009–2013, but was eliminated starting in 2014. Conclusions: Only 73 (17.9%) recommendations generated by the Academy in its 22 clinical practice guidelines are based on a “strong” strength of evidence. More robust research is needed in orthopedics to bolster confidence in the recommendations in future guideline updates.

scholarly journals Hierarchies of Evidence Applied to Lifestyle Medicine (HEALM): Introduction of a Strength-of-evidence Approach Based on a Methodological Systematic Review (P13-023-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
David Katz ◽  
Micaela Karlsen ◽  
Mei Chung ◽  
Marissa Shams-White ◽  
Lawrence Green ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Epigenetic Modification ◽  
Exercise Stress ◽  
Narrative Form ◽  
Lifestyle Medicine ◽  
Strength Of Evidence ◽  
Levels Of Evidence ◽  
Assessment Of Evidence ◽  
Meta Analyses ◽  
Lifetime Effects

Abstract Objectives To characterize strength of evidence (SOE) tools in recent use, identify their application to lifestyle medicine, and to assess implications of the findings. Methods The search strategy was created in PubMed and modified as needed for four additional databases: Embase, AnthropologyPlus, PsycINFO, and Ageline. Systematic reviews and meta-analyses were included if they used a specified SOE tool. There were seven interventions or exposures of interest: diet, exercise, stress, social relationships/support, addiction(s), sleep, and genetic-based factors with potential for epigenetic modification. Data was collected for each SOE tool and summarized in narrative form with regard to the conditions necessary for assigning the highest SOE grading and treatment of prospective cohort studies within each SOE rating framework was qualitatively summarized. The expert panel convened to discuss the findings and their implication for assessing evidence in the domain of lifestyle medicine. Results A total of 15 unique tools were identified. All tools rated SOE using three to five levels of evidence, with the exception of one that uses two levels. Ten were tools developed and used by governmental agencies or other equivalent professional bodies and were applicable in a variety of settings. Five require consistent results from RCTs of high quality to award the highest rating of evidence. Except for the Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence, specific mention of cohort studies was made only to note their secondary contribution to overall SOE as compared to RCTs, unless RCTs were methodologically flawed. A new construct, Hierarchies of Evidence Applied to Lifestyle Medicine (HEALM), was developed to evaluate SOE for the lifetime effects of health behaviors. Conclusions The best metric for SOE varies with research questions and the methods required to answer them. Assessment of evidence relevant to lifestyle medicine requires a potential adaptation of SOE approaches when outcomes and/or exposures obviate exclusive or preferential reliance on RCTs. Funding Sources Supported by the American College of Lifestyle Medicine, with additional funding from the Centers for Disease Control, grant 5U48DP005023–04. Supporting Tables, Images and/or Graphs

scholarly journals The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of synbiotics

2020 ◽  
Vol 17 (11) ◽  
pp. 687-701 ◽  
Author(s):  
Kelly S. Swanson ◽  
Glenn R. Gibson ◽  
Robert Hutkins ◽  
Raylene A. Reimer ◽  
Gregor Reid ◽  
...  
Keyword(s):  
Consensus Statement ◽  
Health Benefit ◽  
Levels Of Evidence ◽  
Definition Of

Abstract In May 2019, the International Scientific Association for Probiotics and Prebiotics (ISAPP) convened a panel of nutritionists, physiologists and microbiologists to review the definition and scope of synbiotics. The panel updated the definition of a synbiotic to “a mixture comprising live microorganisms and substrate(s) selectively utilized by host microorganisms that confers a health benefit on the host”. The panel concluded that defining synbiotics as simply a mixture of probiotics and prebiotics could suppress the innovation of synbiotics that are designed to function cooperatively. Requiring that each component must meet the evidence and dose requirements for probiotics and prebiotics individually could also present an obstacle. Rather, the panel clarified that a complementary synbiotic, which has not been designed so that its component parts function cooperatively, must be composed of a probiotic plus a prebiotic, whereas a synergistic synbiotic does not need to be so. A synergistic synbiotic is a synbiotic for which the substrate is designed to be selectively utilized by the co-administered microorganisms. This Consensus Statement further explores the levels of evidence (existing and required), safety, effects upon targets and implications for stakeholders of the synbiotic concept.

Introductory paper

1966 ◽  
Vol 24 ◽  
pp. 3-5
Author(s):  
W. W. Morgan
Keyword(s):  
Line Intensity ◽  
Classification Scheme ◽  
Two Dimensional ◽  
Spectral Classification ◽  
Dimensional Array ◽  
Rr Lyrae ◽  
Metallic Line ◽  
Introductory Paper ◽  
Parameter Varying ◽  
Definition Of

1. The definition of “normal” stars in spectral classification changes with time; at the time of the publication of theYerkes Spectral Atlasthe term “normal” was applied to stars whose spectra could be fitted smoothly into a two-dimensional array. Thus, at that time, weak-lined spectra (RR Lyrae and HD 140283) would have been considered peculiar. At the present time we would tend to classify such spectra as “normal”—in a more complicated classification scheme which would have a parameter varying with metallic-line intensity within a specific spectral subdivision.

2.2. Working Group 2: Conceptual Definitions of Reference Coordinate Systems for Earth Dynamics

1975 ◽  
Vol 26 ◽  
pp. 21-26
Keyword(s):  
Coordinate System ◽  
Working Group ◽  
General Character ◽  
Coordinate Systems ◽  
Reference Coordinate System ◽  
Group 2 ◽  
Definition Of ◽  
Earth Dynamics

An ideal definition of a reference coordinate system should meet the following general requirements:1. It should be as conceptually simple as possible, so its philosophy is well understood by the users.2. It should imply as few physical assumptions as possible. Wherever they are necessary, such assumptions should be of a very general character and, in particular, they should not be dependent upon astronomical and geophysical detailed theories.3. It should suggest a materialization that is dynamically stable and is accessible to observations with the required accuracy.

Symbiotic Stars at Optical, Infrared and Radio Wavelengths

1979 ◽  
Vol 46 ◽  
pp. 125-149 ◽  
Author(s):  
David A. Allen
Keyword(s):  
Temperature Regime ◽  
Type Star ◽  
Stellar Systems ◽  
Symbiotic Stars ◽  
Lower Excitation ◽  
Definition Of ◽  
Original Type

No paper of this nature should begin without a definition of symbiotic stars. It was Paul Merrill who, borrowing on his botanical background, coined the termsymbioticto describe apparently single stellar systems which combine the TiO absorption of M giants (temperature regime ≲ 3500 K) with He II emission (temperature regime ≳ 100,000 K). He and Milton Humason had in 1932 first drawn attention to three such stars: AX Per, CI Cyg and RW Hya. At the conclusion of the Mount Wilson Ha emission survey nearly a dozen had been identified, and Z And had become their type star. The numbers slowly grew, as much because the definition widened to include lower-excitation specimens as because new examples of the original type were found. In 1970 Wackerling listed 30; this was the last compendium of symbiotic stars published.

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