Levels of evidence

When you pick up an issue of Neurology® and scan its contents, how do you decide what to read? And how do you decide if what you read should change your clinical practice? The value of a scientific study can be assessed by a variety of objective and subjective measures and its value will depend on your perspective. Do you view the results as a researcher or as a practicing neurologist seeking the best evidence on which to make clinical decisions? Readers will naturally assess whether the article’s focus aligns with their interests, either investigative or care-based; whether the findings answer a question relevant to those pursuits; and whether the results are robust enough to serve as a definitive basis for informing their work. In short, readers will be assessing the strength of evidence presented. We might all agree in principle with the notion that the practice of medicine ought to be based on evidence; yet there are situations for which there is little to no evidence, and others for which the evidence is of varying strength. A simple standardized system that can organize the evidence would make such an assessment easier.

At Neurology, we are dedicated to bringing our readers the most relevant and sound scientific research, focusing largely although not exclusively on human subjects. We also publish Practice Parameters and Clinical Guidelines that assess the primary literature and allow readers to see a summary of the strengths and limitations of those studies. In turn, those analyses …