The highest or strongest levels of evidence appear near the top of the Evidence Pyramid, and can be harder to find (if such evidence exists at all).
Not sure where on the evidence pyramid to place an article you have found? Not sure what type of study design is being used? This article may help you decide...
Secondary sources are summaries and analyses of the evidence derived from and based on primary sources. They provide an appraisal of the quality of studies and often make recommendations for practice.
Clinical Practice Guidelines (CPGs) are practice recommendations based on the best available evidence written by healthcare organizations. Guidelines are meant as recommendations for evidence-based patient care.
Search the library databases or try the following suggestions and links...
For specific guidelines use a search engine with the following keywords:
"clinical practice guidelines" AND "your topic"
e.g. "clinical practice guidelines" AND "chronic pain"
Systematic Reviews (SRs) focus on peer-reviewed publications about a specific problem. Rigorous, standardized methods for selecting and assessing articles are used to limit bias in the assembly, critical appraisal, and synthesis of all relevant studies on a specific topic.
A systematic review may or may not include a Meta-Analysis (MA) which is a quantitative summary of the results.
Search the library databases or try the following suggestions and links...
A Critically Appraised Topic (CAT) is a short summary of the best available evidence, created to answer a specific clinical question. it is liked a concise and less rigorous version of a systematic review.
Search the library databases (just add the phrase "critically appraised topic" to your search, or try the links below...
Critically Appraisal Articles (CAA) are structured abstracts and expert commentaries for a particular topic. In certain databases, they are also also known as Review Articles.
Protocol
A defined framework that outlines the care to be provided to patients in a specific area of practice. It focuses on the rationale, timing, location, and the individuals responsible for delivering the care, rather than detailing the steps of a procedure.
SAMPLE ARTICLE : [ Protocol ]
Standard
A consensus-based statement that clearly defines the desired outcome, typically used in audits as a measure of success.
SAMPLE ARTICLE : [ Standards of Medical Care in Diabetes ]
Guideline
Statements derived systematically to assist practitioners in making decisions about care in specific clinical situations. These should be based on research or evidence.
SAMPLE ARTICLE : [ Jaundice in newborn babies under 28 days ]
Primary sources in the field of medical and health sciences are typically journal articles detailing original research. They are important because they are often the original sources of new knowledge. An example of a primary sources is a quantitative or qualitative research study that describes an intervention and its outcome on a specific population.
Search the library databases or try the following links...
Professional organizations are a great place to start looking for current events, issues facing practitioners, and conflicts within the health law arena.
Policy
A formal written statement detailing the particular action to be taken in a particular situation that is contractually binding.
SAMPLE ARTICLE : [ Policy ]
Regulation
The core purpose of the legislation was to give the public the right to make decisions about their life and healthcare. It is crucial for you to understand the relevant regulations in order to make binding, legally enforceable decisions for both yourself and your patients.
SAMPLE ARTICLE : [ PHMC Act ]
Grey literature consists of research and information produced outside of traditional academic publishing, often falling into the category of Primary Research.
According to Phillips et al., (2023) grey literature is essential for evidence-based nursing, providing critical information that is often overlooked in traditional scholarly resources. Gray literature plays a crucial role by:
Reducing Publication Bias
Filling Information Gaps
Accessing Recent Clinical Research
| Types of Grey Literature | Publications |
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ACADEMIC - not all academic resources are scholarly and peer-reviewed. A lot of the information made available by academics is known as grey literature. |
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PRIMARY SOURCES - resources that reflect views, memories, or immediate responses to events. |
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NON-ACADEMIC RESEARCH & REPORTS - documents created by non-academic organizations researching topics outside academia. Think tanks, policy institutes, research centers, and governments fall into this category. |
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HEALTH - documents related to the fields of health and medicine, designed to be used by experts in the field. |
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TECHNICAL - covers highly specialized information on the interworking of different procedures, inventions, technologies, engineering advancements, scientific discoveries, and more. Intended audience are fellow technical experts. |
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INDUSTRY & COMMERCIAL - items created to inform businesses, consumers, and industry professionals about products, markets, and industry trends. |
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| PROGRAM OR PUBLIC INFORMATION - items made to report or inform outside audiences of an individual organization's activities. This can be done by businesses, think tanks, government agencies, academic organizations, and more. They are not research-based and are made for general consumption. |
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CC.BY.SA.4.0 Adapted from Vanderbilt University Libraries Research Guides under the same license.
International human clinical studies on a wide range of diseases and conditions.
Information on interventional clinical trials on medicines conducted in the European Union (EU), or the European Economic Area (EEA) which started after 1 May 2004. (also available on the WHO International Clinical Trials Registry Platform).
This UK clinical studies registry accepts all clinical research studies involving human subjects or populations with outcome measures assessing effects on human health and well-being, including studies in healthcare, social care, education, workplace safety and economic development.
An free academic and clinical focused service that freely collects, preserves, and disseminates full-text nursing research, educational, and evidence-based practice materials in a variety of formats and item types.
The main aim is to facilitate the prospective registration of the World Health Organisation trial registration data set on all clinical trials, and the public accessibility of that information.
Peer-reviewed open access online journal publishing proceedings from conferences, including both peer-reviewed full articles and collections of meeting abstracts.
SIT Library database -select the Document Types filter for Proceeding Paper.
Preprint archive for Computer Science, Economics, Electrical Engineering, Mathematics, Physics, Quantitative Biology, Quantitative Finance, Statistics, and Systems Science.
Directory of preprint servers.
Preprint server for Biology.
Preprint server for Education.
Preprint server for Health Sciences.
Federated preprint search engine by Open Science Framework.
Free preprint multidisciplinary server.
Preprint service for the Psychological Sciences.
Preprint server for Computer Science, Engineering, and related Technology.
Use the following ProQuest databases from the Singapore National Library, using the limiter Source Types Dissertations & Theses
- Healthcare Administration
- Public Health
- Nursing & Allied Health
Find open access graduate theses and dissertations published around the world.
General search engines that does not track searches or manipulate search results based on the user (less bias).
- search within a website site:nih.gov diabetes
- a lot of grey literature is is PDF format filetype:pdf depression
- a lot of grey literature also comes from .gov, .org, .edu domains .gov obesity
- you can also combine these different types of Google searches.
Directory of organizations that host online repositories of self-published documents, categorized by subject.
Free, medically-focused deep web search engine.
Includes technical or research reports, doctoral dissertations, some conference papers, some official publications, and other types of grey literature from the European Union.