Explore the five Levels of evidence to use while making educated determinations about prescribing and care.
Level 1 studies are scientific studies in which subjects are randomly assigned a condition of the independent variable; the treatment groups are compared against a control group; all subjects are recruited from the same eligible population. These studies are often used to evaluate medication efficacy and treatment efficacy. These studies can only include prospective data.
Level 2 studies are scientific studies in which subjects from the eligible population are assigned a non-random condition based on factors such as demographic data, previous treatments, or participant choice. These studies are often used to evaluate cause-and-effect relationships and interventions that cannot be randomized. These studies can include retroactive or prospective data.
Level 3 studies are scientific studies in which a variable is observed and measured without being manipulated. These studies can be used to evaluate phenomena as they exist without intervention and aim to explain how a variable naturally exists. These studies can include retroactive or prospective data. These studies cannot be used to explore cause-and-effect relationships.
Level 4 recommendations are based on the conclusions of multiple experts, such as those belonging to a committee, based on previous scientific research. This evidence can also include clinical practice guidelines that are followed by the majority of experts in the field.
Level 5 recommendations are based on the opinions of individual experts based on their own professional experiences. This evidence can also include literature reviews of relevant studies, case reports, and institutional reviews of data.
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Cite this work:
OPEN: Overdose Prevention Engagement Network (2024). Hierarchy of Evidence for Opioid Prescribing Recommendations. Retrieved from https://doi.org/10.56137/OPEN.000077