A medical panelprepared guidelines for when cardiac pacemakersshould be implante

Question

A medical panelprepared guidelines for when cardiac pacemakersshould be implanted in patients with heart problems. The panelreviewed a large number of medical studies to judge the strength ofthe evidence supporting each recommendation. For eachrecommendation, they ranked the evidence as level A (strongest) , Bor c (weaker). Here, in scrambled order, are the panel'sdescriptions of the three levels of evidence. Which is A, which B,and Which C? Explain your ranking:

Evidence was ranked as level _____ when data were derived from alimited number of trials involving comparatively small numbers ofpatients or from well-designed data analysis of nonrandomizedstudies or observational data registries.

Evidence was ranked as level ____ if the data were derived frommultiple randomized clinical trials involving a large number ofindividuals.

Evidence was ranked as level ____ when consensus of expert opinionwas the primary source of recommendation.

Explanation / Answer

The first description is level B because it's stronger thanopinion, but not as strong as experiments with large number ofsubjects. The second description referts to experiements (clinicaltrials) and large samples; that is the strongers evidence, so levelA.

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