Dear Declan:
Interesting to see a query from the urological literature; this may be the first time.
As stated by others previously, the CEBM grading system considers high quality evidence from inception cohort studies as level I evidence for questions of PROGNOSIS. I'd make sure though that what you are looking at is not a surgical case series and that the question is indeed one of prognosis (not therapy).
I'm afraid I'd place relatively little stock in the authority of the authors or the journal....
Happy to discuss further off-line. Always keen to meet other urologists interested in EBM!
Greetings from Florida.
Ph*
Philipp Dahm, MD, MHSc, FACS
Associate Professor of Urology, Associate Residency Program Director & Director of Clinical Research
Department of Urology
University of Florida
College of Medicine, Health Science Center
Box 100247, Room N2-15
Gainesville, FL 32610-0247
Phone: (352) 273-7936
Fax: (352) 273-7515
Email: [log in to unmask]
Website: http://evidence-based.urology.ufl.edu
-----Original Message-----
From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Declan Murphy
Sent: Saturday, October 31, 2009 3:08 AM
To: [log in to unmask]
Subject: Inception cohort study and level I evidence
Sorry to bother you guys with a query. I am reviewing a paper which claims to be CEBM Level Ib as it is an "inception cohort study with over 80% follow-up". It is not an RCT, it is simply a large surgical cohort followed prospectively for a few years and the data is not comparative in any way. Seven or eight papers have been published from this series previously but this is the first time they have claimed level Ib evidence status. Is it appropriate for the authors to claim this is Level Ib evidence and to reference the CEBM in support? The authors are well known in urology and this paper is under submission to the leading urology journal so I am anxious to ensure they are not discrediting the CEBM levels with this claim.
I would very much appreciate your advice.
declan
Mr Declan G Murphy FRCS Urol
Consultant Urologist
The Urology Centre
Guy's Hospital
St Thomas' Street
London
SE1 9RT
Tel: +44(0)7880 731254
www.gstt.nhs.uk/urology
www.youtube.com/decmurphyurology
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