Evidence, hierarchies, and typologies: horses for courses: Table 1
Open accessAbstract
Debate is ongoing about the nature and use of evidence in public health decision making, and there seems to be an emerging consensus that the “hierarchy of evidence” may be difficult to apply in other settings. It may be unhelpful however to simply abandon the hierarchy without having a framework or guide to replace it. One such framework is discussed. This is based around a matrix, and emphasises the need to match research questions to specific types of research. This emphasis on methodological appropriateness, and on typologies rather than hierarchies of evidence may be helpful in organising and appraising public health evidence.
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While non-randomised studies are at increased risk of bias, there is an argument that poor quality RCTs may be lower value than well-conducted non-randomised controlled trials.
“While we acknowledge that non-randomised studies are at increased risk of bias, there is an argument that poor quality RCTs may be lower value than well-conducted non-randomised controlled trials [88,89].”
From Interventions targeting social isolation in older people: a systematic review (2011) · cites this paper as [89]
A major shortcoming of the level-of-evidence approach is that it may result in a high level of evidence irrespective of the actual magnitude of benefit observed, even if that magnitude is very limited.
“A major shortcoming of this approach is that it may result in a high level of evidence irrespective of the actual magnitude of the benefit observed, even if the magnitude of the benefit is very limited [148].”
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- Authors
- Petticrew, M., & Roberts, H.
- Affiliations
- MRC/CSO Social and Public Health Sciences Unit (GB)
- City, University of London (GB)
- Corresponding author
- Petticrew, M
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 2003-07
- Volume
- 57
- Issue
- 7
- Pages
- 527-529
- ISSN
- 0141-7681 (ISSN-L)
- 0143-005X
- 1470-2738
- PMC
- PMC1732497
- OpenAlex
- W2133490696
- Cited by
- 539
- References
- 31
- Citations by year
- 2026: 11 · 2025: 13 · 2024: 15 · 2023: 9 · 2022: 21 · 2021: 46 · 2020: 30 · 2019: 27 · 2018: 31 · 2017: 33 · 2016: 41 · 2015: 34 · 2014: 27 · 2013: 42 · 2012: 24
- FWCI
- 20.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Epidemiology & Community Health (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- University of Glasgow
- Medical Research Council
- Economic and Social Research Council
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Health Sciences › Health Professions › Health Information Management › Methodologies in Health Research and Practice
- Keywords
- evidence hierarchy, public health decision-making, evidence appraisal, research typology, evidence-based public health
- MeSH terms
- Decision Making, Humans, Policy Making, Public Health, Public Policy, Practice Guidelines as Topic
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