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When using this model to guide clinical decision making, begin your search at the highest possible layer in the 6S model.

Read this article for an overview of the 6S model and how it relates to your search for best evidence to inform clinical practice.

DiCenso, A., Bayley, L., & Haynes, B. (2009). Accessing pre-appraised evidence: fine tuning the 5S model into a 6S model. Evidence-Based Nursing, 12(4), 99-101.

Click to Select a Type of Evidence

Click on a level of evidence to find appropriate resources:

Systems is the top level of the 6s pyramid. Example: evidence-based clinical information system. This level of the pyramid is grey on the image being described.
Summaries are the second level from the top of the 6s pyramid. Examples: practice guideline, evidence summary. This level of the pyramid is yellow on the image being described.
Synopses of syntheses are the third level from the top of the 6s pyramid. Example: pre-appraised systematic review. This level of the pyramid is pale red on the image being described.
Syntheses are the fourth level from the top of the 6s pyramid. Example: systematic review. This level of the pyramid is pink on the image being described.
Synopses of single studies are the second level from the bottom of the 6s pyramid. Example: pre-appraised single study. This level of the pyramid is blue on the image being described.
Single studies is the bottom level of the 6s pyramid. Example: randommized controlled trial, cohort study. This level of the pyramid is green on the image being described.

Understanding the 6S Pyramid

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