Friday, July 21, 2017 9:21:44 PM
Level 1 evidence is the most reliable studies upon which medical treatment decisions are made, and the criteria for levels 1 through 5 are outlined below:
1. Blinded randomized controlled trial with statistically significant differences and appropriate confidence intervals.
2. Randomized controlled trial without proper randomization, blinding, or poor follow up
3. Case control or retrospective study.
4. Case series. (For example, a paper outlining how I fixed a torn tendon in x number of patients and it worked. The overwhelming majority of published medical literature fits into this category)
5. Expert opinion.
Note that Sucanon outperformed Glyburide in a 6 month randomized double blind placebo controlled trial (level 1 evidence, highest reliability) in terms of fasting blood sugar reduction, excretion of urinary glucose, and glucose tolerance testing.
The trial in prediabetics in which 81% showed normalized HbA1C levels after 12 weeks of Sucanon is level 3 since not placebo controlled but was peer reviewed and presented at the prestigious EASD 2013 annual meeting and published in their journal.
I could claim expert opinion (level 5) based on training but instead claim only that my facts are independently verifiable from public sources so any can check as desired. Note that level 4 and 5 is the usual treatment opinion you get from your doctor if specific higher level evidence is not available or consulted.
Jacob J. Rosenblum on what every lawyer knows.
“If the facts are against you, hammer the law. If the law is against you, hammer the facts. If the fact and the law are against you, hammer opposing counsel."
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