A nurse working on a PICO question has found a large amount of literature available on the topic with multiple studies that have been published. Which type of study should have the best evi-dence?
a. Meta-analysis of randomized control trials
b. Opinion of an expert committee
c. One well-designed randomized control trial
d. Systematic review of descriptive and qua-litative studies
A
Systematic reviews or meta-analyses are state-of-the-science summaries from an individual re-searcher or panel of experts and are on the highest level of the hierarchy. These research summa-ries are the perfect answers to PICO(T) questions because the researchers have rigorously sum-marized all current evidence on the question. A single RCT is not as conclusive as a review of several RCTs on the same question. Opinion of an expert committee is on the lowest level of the hierarchy of evidence. Systematic review is above opinions but is below meta-analysis on the hierarchy of evidence.
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