Dear Declan
Without knowing the type of clinical question, I cannot say whether the claim is appropriate. The CEBM has different hierachies for different types of question: therapy, prognosis, diagnosis, etc. For prognosis, the best single study is an inception cohort. This will usually be better than an RCT because of better representative and enroling patients at the same stage of disease. So if the study question is one of prognosis, then the claim may be reasonable. For example, if you were interested in the hernia recurrence rate after an operation then an inception cohort is appropriate. If you were interested in which of two procedures had the lower recurrence rate then an RCT is needed.
Best wishes
Paul Glasziou
Paul Glasziou
Dept Primary Health Care,
University of Oxford, Old Road Campus,
Old Rd, Headington, OX3 7LF
www.cebm.net
>>> Yennunanda Vishnugopal <[log in to unmask]> 16/11/09 23:01 >>>
On Sat, 31 Oct 2009 07:08:19 +0000
Declan Murphy <[log in to unmask]> wrote:
> 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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