EBP 6S Pyramid Guided Search
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Your pathway through EPOCH resources to help prioritise best evidence for decision-making and research.
The 6S Pyramid Guided Search is an evidence-based practice tool that presents a course of action for the busy practitioner who wants to search EPOCH resources for the highest quality research most relevant to their issue of interest, quickly and efficiently.
We recommend you clearly define your clinical/research question or problem before using this tool.
About EPOCH resources
EPOCH resources provide two broad types of health research:
Filtered research
Also called secondary or pre-appraised research. This is synthesised or summarised evidence drawing from evaluated primary, single studies on a topic.
Examples of filtered research are evidence summaries, guidelines, systematic/scoping reviews and meta-analyses.
Unfiltered research
Also called primary research. This body of evidence consists of original, single studies that require critical appraisal or evaluation by the reader.
Examples of unfiltered research are controlled trials, cohort studies, qualitative studies, and case-control studies.
The 6S Pyramid model
The 6S Pyramid model arranges all available research into a six-level hierarchy. The bottom level represents unfiltered, primary research.
As you move up through the five levels of filtered research, the methodological quality of evidence and its ability to guide practitioner action increases.
Using the Guided Search
Guide your decision-making or research by starting at the highest possible level of the 6S Pyramid to check if the body of evidence on your topic is synthesised and appraised in an EPOCH resource.
Work down the 6S Pyramid through the different levels of filtered research and search for primary single studies as the last option.
*Filtered Research pre-appraises primary research but it is recommended that an appraisal checklist is used to verify the quality of Guidelines and Systematic Reviews.
This Guide adapts
- DiCenso, Bayley and Haynes. (2009). Accessing preappraised evidence: Fine-tuning the 5S model into a 6S model. Annals of Internal Medicine, 151(6), JC3.
- McMaster University Health Sciences Library. (2022, July 26). Resources for evidence-based practice: The 6S pyramid. McMaster University. https://hslmcmaster.libguides.com/ebm
The ideal source of evidence for decision-making. SYSTEMS integrate information from the lower levels of the 6S Pyramid with patients' electronic health records.
Also called Computerised Decision Support Systems these are outside the scope of EPOCH.
Skip to the next level on the 6S Pyramid Level 5 Summaries.
Regularly updated guidelines and summaries that integrate evidence-based information for whole clinical/health topics.
To determine quality and methodological rigour of a guideline use the AGREE II Instrument.
TRIP Database
EPOCH's meta-search engine TRIP allows searching for evidence across multiple resources at all levels of the 6S Pyramid.
Use for
- Guidelines
Point of care
DynaMed
Clinical decision support tool for quick evidence at the point of care.
Use for
- Summaries
- Guidelines
UpToDate [Onsite Only]
Clinical decision support tool for quick evidence at the point of care.
Use for
- Summaries
- Guidelines
JBI EBP Database
Clinical point of care resources for all specialties.
Use for
- Evidence summaries
- Recommended practices
- Best practice information sheets
Therapeutic Guidelines
Australian clinical decision support tool for quick evidence at the point of care.
Use for
- Summaries
- Guidelines
HealthPathways Tasmania [Onsite Only]
Localised best practice assessment and management.
Use for
- Pathways
- Guidelines
ClinicalKey Clinical Overviews [Onsite Only]
Comprehensive clinical topic summaries.
Use for
- Summaries
Guidelines
EPOCH Specialty Guides
Browse selected national and international guidelines organised by specialties.
NICE Guidance
UK guidelines, quality standards and advice to guide decisions in health, public health and social care.
MEDLINE Guidelines Search Filter
Apply a pre-made GUIDELINES search strategy in core biomedical research database MEDLINE.
CINAHL Guidelines Search Filter
Apply a pre-made GUIDELINES search strategy in nursing and allied health research database CINAHL.
EPOCH A-Z Guidelines & Standards
Browse EPOCH's directory of guidelines and standards.
Summaries of systematic reviews. Evidence at this level often provides sufficient information to support practitioner action.
TRIP Database
EPOCH's meta-search engine TRIP allows searching for evidence across multiple resources at all levels of the 6S Pyramid.
Use for
- Synopses
Databases
Campbell Collaboration
Provides plain language summaries of Campbell Collaboration social care and welfare systematic reviews.
Cochrane Plain Language Summaries
Provides summaries that aid translation of findings in Cochrane systematic reviews.
HealthEvidence.org
Provides summaries of selected systematic reviews on effectiveness of public health and health promotion interventions.
Abstract journals
Journals that provide a summary and clinical commentary about selected high-quality systematic reviews.
- ACP Journal Club [Onsite Only]
- Cancer Treatment Reviews
- Evidence-Based Dentistry
Other
Canada's Drug & Health Technology Evidence Bundles
Topic-specific summaries of high-quality systematic reviews.
Sax Institute Evidence Checks
Concise summaries of evidence on specific issues that inform Australian health policies, programs and services.
A comprehensive synthesis of all the evidence surrounding a specific research question.
To determine quality and value for practice of an evidence synthesis use CASP checklist for Systematic Reviews.
TRIP Database
EPOCH's meta-search engine TRIP allows searching for evidence across multiple resources at all levels of the 6S Pyramid.
Use for
- Systematic reviews
Databases
JBI EBP Database
Clinical point of care resources for all specialties.
Use for
- Scoping reviews
- Systematic reviews
AHRQ Evidence-Based Practice Center Reports
Healthcare quality and effectiveness reviews.
Campbell Collaboration
Social care and welfare evidence syntheses.
Cochrane Library
Gold-standard quality systematic reviews, meta-analyses and controlled trials.
Cochrane Neonatal Reviews
Interventions and treatment for neonatal diseases or problems.
OTseeker
Occupational therapy interventions and treatment.
PEDro
Physiotherapy interventions and treatment.
PubMed Clinical Queries
Systematic reviews for clinical or disease-specific topics.
EPOCH A-Z Evidence-Based Practice
Browse EPOCH's directory of resources that publish evidence syntheses.
Other
CINAHL Systematic Reviews & Meta-Analyses Search Filter
Apply a pre-made SYSTEMATIC REVIEW search strategy in nursing and allied health research database CINAHL.
MEDLINE Systematic Reviews & Meta-Analyses Search Filter
Apply a pre-made SYSTEMATIC REVIEW search strategy in core biomedical research database MEDLINE.
Summaries of evidence in single high-quality studies.
TRIP Database
EPOCH's meta-search engine TRIP allows searching for evidence across multiple resources at all levels of the 6S Pyramid.
Use for
- Synopses
Abstract journals
Journals that provide a summary and clinical commentary about selected single studies.
- ACP Journal Club [Onsite Only]
- Cancer Treatment Reviews
- Evidence-Based Dentistry
Other
NIHR Evidence
Plain language summaries of health and social care research funded by the UK National Institute for Health & Care Research.
Canada's Drug & Health Technology Evidence Bundles
Topic-specific summaries of high-quality research.
Unique primary research conducted to answer specific questions.
To determine quality and value for practice of a study use an appropriate critical appraisal tool from CASP Checklists.
TRIP Database
EPOCH's meta-search engine TRIP allows searching for evidence across multiple resources at all levels of the 6S Pyramid.
Use for
- Randomised controlled trials and other high-quality primary research
Research databases
PubMed Clinical Queries
Clinical trials for clinical- or disease-specific topics.
MEDLINE
Principal database across all biomedical specialties.
Embase
Principal database of biomedical and pharmaceutical research.
CINAHL
Nursing and allied health research.
Ovid Emcare
Nursing and allied health research.
EPOCH A-Z Research Databases
Browse EPOCH's directory of research databases.
