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Evidence-Based Practice

Resources to support your evidence-based practice.

Study Design

Glossary of Terms

Case Control Studies [MeSH]* - Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.

Clinical Trial [MeSH Publication Type]* - Work that is the report of a pre-planned clinical study of the safety, efficacy, or optimum dosage schedule of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques in humans selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. While most clinical trials concern humans, this publication type may be used for clinical veterinary articles meeting the requisites for humans. Specific headings for specific types and phases of clinical trials are also available.

Cohort Studies [MeSH]* - Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.

Consensus Development Conference [MeSH Publication Type]* - A work that consists of summary statements representing the majority and current agreement of physicians, scientists, and other professionals meeting to reach a consensus on a selected subject.

Controlled Clinical Trial [MeSH Publication Type]* - Work consisting of a clinical trial involving one or more test treatments, at least one control treatment, specified outcome measures for evaluating the studied intervention, and a bias-free method for assigning patients to the test treatment. The treatment may be drugs, devices, or procedures studied for diagnostic, therapeutic, or prophylactic effectiveness. Control measures include placebos, active medicine, no-treatment, dosage forms and regimens, historical comparisons, etc. When randomization using mathematical techniques, such as the use of a random numbers table, is employed to assign patients to test or control treatments, the trial is characterized as a RANDOMIZED CONTROLLED TRIAL.

Follow-up Studies [MeSH]* - Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.

Longitudinal Studies [MeSH]* - Studies in which variables relating to an individual or group of individuals are assessed over a period of time.

Meta-Analysis [MeSH Publication Type]* - Works consisting of studies using a quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc. It is often an overview of clinical trials. It is usually called a meta-analysis by the author or sponsoring body and should be differentiated from reviews of literature.

Practice Guideline [MeSh Publication Type]* - Work consisting of a set of directions or principles to assist the health care practitioner with patient care decisions about appropriate diagnostic, therapeutic, or other clinical procedures for specific clinical circumstances. Practice guidelines may be developed by government agencies at any level, institutions, organizations such as professional societies or governing boards, or by the convening of expert panels. They can provide a foundation for assessing and evaluating the quality and effectiveness of health care in terms of measuring improved health, reduction of variation in services or procedures performed, and reduction of variation in outcomes of health care delivered.

Randomized Controlled Trial [MeSH Publication Type]* - Work consisting of a clinical trial that involves at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.

Systematic Review**-A systematic review attempts to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a given research question. Researchers conducting systematic reviews use explicit methods aimed at minimizing bias, in order to produce more reliable findings that can be used to inform decision making.

*National Library of Medicine's Medical Subject Heading (MeSH) definition

**From http://www.cochranelibrary.com/about/about-cochrane-systematic-reviews.html

Question Types and Study Design

Question Type Description Best Types of Evidence
Therapy how to select treatments to offer our patients that do more good than harm and that are worth the efforts and costs of using them Randomized Controlled Trial (RCT)
Diagnostic tests how to select and interpret diagnostic tests, in order to confirm or exclude a diagnosis, based on considering their precision, accuracy, acceptability, expense, safety, etc Prospective, blind comparison to gold / reference standard
Prognosis how to estimate a patient's likely clinical course over time due to factors other than interventions Cohort Study > Case Control Study > Case Series
Harm/Etiology how to identify causes for disease (including its iatrogenic forms) Cohort Study > Case Control Study > Case Series
Prevention how to reduce the chance of disease by identifying and modifying risk factors and how to diagnose disease early by screening RCT > Cohort Study > Case Control Study > Case Series

Adapted from Duke University Medical Center Library and Archives