About This Page
The resources found in the 6S Pyramid contain evidence that will help you answer foreground questions (queries that bring together multiple concepts related to a specific clinical situation or research topic).
[Adapted from DiCenso, Bayley and Haynes (2009). ACP Journal Club. Editorial: Accessing pre-appraised evidence: Fine-tuning the 5S model into a 6S model. Annals of Internal Medicine, 151(6):JC3-2, JC3-3.]
The 6S pyramid is arranged in a hierarchy, with the different levels outlined and colour-coded to the right of this page
Use the concepts identified in your PICO or PS Question (found in the Forming Questions tab) to come up with approriate search terms, remembering:
- A piece of evidence's ability to guide clinical action increases as you move up the pyramid.
- Topics become more specific as you move down the pyramid.
More Tips
- Watch HSL's Database Fundamentals Tutorial to learn the basics of effective and efficient searching.
- Visit the Background Information tab for answers to more general questions (e.g. Terminology, Drug Info, etc.)
- Visit the About EBP tab for a more detailed description of the concepts underlying Evidence-Based Practice
Off-Campus Access
The small lock icon 
beside a link indicates this is an online library resource. When you click on the resource link from off-campus you'll be redirected to a login page. Login using your MacID and password to access the content.
Grey Literature
- ProceedingsFirst This link opens in a new window An index of conference publications from worldwide meetings, conferences, expositions, workshops, congresses, and symposia. Provides an overview of the event's activities by listing the papers presented.
- ProQuest Dissertations & Theses Global This link opens in a new window Coverage: 1980- Indexes over 2 million doctoral dissertations and master's theses completed at accredited North American and selected European colleges and universities. Dissertations published from 1980 forward include 350 word abstracts written by the author. Master's theses published from 1988 forward include 150 word abstracts. Includes full-text access to many McMaster theses (send an email to request one). For other institutions, 24 page previews are available. In most cases, this will be graduate works published since 1997.
Additional Information Sources
Business/Administration
- Healthstar/Ovid Healthstar This link opens in a new window Health services, technology, administration, and research
Consumer Health
Drug Therapy
Education
Physiotherapy
- PEDro This link opens in a new window Contains randomized trials, systematic reviews, and clinical practice guidelines.
Public Health
- HealthEvidence.org Searches multiple databases for systematic reviews on public health interventions.
- Public Health + Studies and systematic reviews in public health.
Sociology
- The Campbell CollaborationSystematic reviews in education, crime and justice, social welfare, and international development
- Sociological Abstracts This link opens in a new window Containing articles in the field of sociology
Citing Sources
American Psychological Associations (APA) Style Guides
Vancouver Style Guides
- Uniform Requirement for Manuscripts Submitted to Biomedical Journals• For a list of sample citations, click here
- Monash UniversityInteractive Tutorial
Citing Evidence-Based Texts
- Citing UpToDateAdapt example citation to appropriate style
Meta-Searches
Meta-Searches search for evidence across multiple resources. These tools return information from all levels of the pyramid:
- Accessss This link opens in a new window Accessss (formerly MacPLUS) Federated Search is designed to find the best evidence-based answer to your clinical questions by simultaneously searching the leading evidence-driven medical publications and high quality clinical literature.
- EpistemonikosMeta-searching in 9 languages.
- SUMSearchUniversity of Kansas
Systems
Integrating information from the lower levels of the hiearchy with individual patient records, systems represent the ideal source of evidence for clinical decision-making.
Summaries
Summaries are regularly updated clinical guidelines or textbooks that integrate evidence-based information about specific clinical problems.
Clinical Practice Guidelines
- NICE Clinical GuidelinesNational Institute for Health and Clinical Evidence, UK
- Evidence-Based Guidelines (Programs in Evidence-Based Care)Cancer Care Ontario
- Best Practice GuidelinesRegistered Nurses Association of Ontario (RNAO)
- Overton This link opens in a new windowOverton is the world’s largest searchable index of policy documents, guidelines, think tank publications and working papers.
Evidence-Based Texts
- DynaMed This link opens in a new window Evidence-based reference tool of diseases, disorders, and symptoms including etiology, history and research findings, diagnosis, prognosis , treatment and prevention and drug information.
This link opens in a new window
- Best Practice This link opens in a new window From BMJ Evidence Centre
- This link opens in a new window
- Clinical Overviews (Through ClinicalKey)Select "Clinical Overviews" from the drop down menu next to the search bar
Synopses of Syntheses
Synopses of syntheses, summarize the information found in systematic reviews. By drawing conclusions from evidence at lower levels of the pyramid, these synopses often provide sufficient information to support clinical action.
- NHS Centre for Reviews and Dissemination (CRD) DARE: Systematic reviews evaluating health care interventions and the delivery of health services. NHA EED: Studies examining two or more interventions and the costs and outcomes associated with them (i.e. Cost-benefit analyses, cost-utility analyses, and cost-effectiveness analyses). HTA: Completed and ongoing health technology assessments from around the world. Grey literature from 72 international health technology assessment organizations.
- OrthoEvidence OrthoEvidenceTM is the source for high quality, current orthopaedic–only evidence-based summaries, pre-appraised by orthopaedic medical experts. OrthoEvidence is intended to provide critical information access to orthopaedic healthcare providers and their patients everywhere.
- HealthEvidence.org Searches multiple databases for systematic reviews on public health interventions.
Evidence-Based Abstract Journals
Syntheses
Commonly referred to as a systematic review, a synthesis is a comprehensive summary of all the evidence surrounding a specific research question.
- EPC Evidence ReportsEvidence-Based Practice Centers
Synopses of Single Studies
Synopses of single studies summarize evidence from high-quality studies. The following evidence-based abstract journals are the best place to find this type of information:
Single Studies
Studies represent unique research conducted to answer specific clincial questions.
Article Databases
Clinical Queries
The CINAHL, OVID (Medline, EMBASE, PsychINFO), and Pubmed databases can be searched using the Clinical Queries filter, limiting your results to specific clinical research areas: Therapy, Prognosis, Review, Qualitative, and Causation (Etiology)
For further information and tips on using the Clinical Queries filter, please visit the following links:
- PubMed Clinical Queries This link opens in a new window Pre-filtered PubMed searches for clinicians. Search by Clinical Study Category, Systematic Reviews, and Medical Genetics.
