Evidence map›Paper›PMID 41425288›Full record

ArticleThe Journal of the Canadian Chiropractic Association2025

Conceptualizing the evidence pyramid for use in clinical practice: a narrative literature review.

Paul S Nolet, Peter C Emary, Jonathan Murray, Glen H Harris, Brian Gleberzon, Anita Chopra, Marco De Ciantis, Rod Overton

Abstract read
In one paragraph

Article in The Journal of the Canadian Chiropractic Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. When there is little or no research evidence: a clinical decision tool.The Journal of the Canadian Chiropractic Association · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Paul S NoletDepartment of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, Ontario.
Peter C EmaryMichael G. DeGroote National Pain Centre, McMaster University, Hamilton, Ontario. Chiropractic Department, D'Youville University, Buffalo, New York. Chiropractic Clinician, Langs Community Health Centre, Cambridge, Ontario.
Jonathan MurrayHuman Health and Nutritional Sciences, University of Guelph, Ontario.
Glen H HarrisDivision of Clinical Education, Canadian Memorial Chiropractic College, Toronto, Ontario.
Brian GleberzonPrivate Practice, Toronto, Ontario.
Anita ChopraPrivate Practice, Brampton, Ontario.
Marco De CiantisPrivate Practice, Castlegar, British Columbia.
Rod OvertonPrivate Practice, London, Ontario.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To explore contemporary iterations of the evidence pyramid as applied in evidence-based practice. Methods: We searched for articles published in PubMed, Web of Science, and Scopus databases between 2016 and 2024 that assessed the evidence pyramid and its application in clinical practice. Title/abstract and full-text screening were conducted by one reviewer to determine eligibility, followed by data extraction and analysis to summarize themes. Results: Of 83 full-text articles identified, 28 were included. Extracted information centred on three common themes: (1) use of the evidence pyramid as a guide, not a rigid tool; 2) importance of the clinical question; and (3) necessity of clinical expertise to integrate research findings into clinical decision-making. Conclusion: Preliminary findings of our review suggest that, when applying the evidence pyramid in practice, clinicians should consider context (i.e., the clinical question, best available evidence, patient preferences, and clinical circumstances), to optimize clinical decision-making and patient outcomes. Author’s Note: This paper is one of seven in a series exploring contemporary perspectives on the application of the evidence-based framework in chiropractic care. The Evidence Based Chiropractic Care (EBCC) initiative aims to support chiropractors in their delivery of optimal patient-centred care. We encourage readers to review all papers in the series.

Indexed as

chiropracticclinical competenceclinical decision-makingevidence-based medicineevidence-based practicepatient care

Identifiers

PMID41425288
PMCPMC12716892

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.