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Evidence Based Medicine: Background/Foreground Questions

The 6S heirarchy of evidence

6S Hierarchy of Evidence Based Resources

Developed in 2009 (1), the 6S Hierarchy of Evidence Based Resources is a useful model for guiding clinical decision making.

The model proposes 6 layers of evidence sources. The search for evidence based resources should begin at the highest possible layer.

For more information of each tab:

  1. Systems
  2. Summaries
  3. Synopses of synthesis
  4. Synthesis
  5. Synopses of studies
  6. Studies

6S Model of Evidence


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1. DiCenso A, Bayley L, Haynes RB (2009). Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model. Evidence-Based Nursing, 12(4),99-101.

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