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      The levels of evidence and their role in evidence-based medicine.

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          Abstract

          As the name suggests, evidence-based medicine (EBM), is about finding evidence and using that evidence to make clinical decisions. A cornerstone of EBM is the hierarchical system of classifying evidence. This hierarchy is known as the levels of evidence. Physicians are encouraged to find the highest level of evidence to answer clinical questions. Several papers published in Plastic Surgery journals concerning EBM topics have touched on this subject.– Specifically, previous papers have discussed the lack of higher level evidence in PRS and need to improve the evidence published in the journal. Before that can be accomplished, it is important to understand the history behind the levels and how they should be interpreted. This paper will focus on the origin of levels of evidence, their relevance to the EBM movement and the implications for the field of plastic surgery as well as the everyday practice of plastic surgery.

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          Author and article information

          Journal
          Plast Reconstr Surg
          Plastic and reconstructive surgery
          Ovid Technologies (Wolters Kluwer Health)
          1529-4242
          0032-1052
          Jul 2011
          : 128
          : 1
          Affiliations
          [1 ] Ann Arbor, Mich.; and Dallas, Texas From the Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
          Article
          NIHMS288127 00006534-201107000-00046
          10.1097/PRS.0b013e318219c171
          3124652
          21701348
          50eb1717-3467-47f0-846a-c2f4d5ac559f
          History

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