LEGEND Evidence Evaluation Tools & Resources
At Cincinnati Children’s, we rely on LEGEND (Let Evidence Guide Every New Decision) to help us provide the best patient outcomes. We are also dedicated to sharing what we know. The LEGEND Evidence Evaluation System provides tools and resources to help guide your work in Evidence-Based Decision Making. This system guides you in evaluating the evidence from critical appraisal of the individual study through development of the care recommendation statement.
Following the Algorithm will help identify the study design of an individual study. Based on the domain and design of each study, using the Evidence Appraisal Forms will help evaluate the validity, reliability, and applicability then determine the Evidence Levels of each individual study, as studies relate to the clinical question. Once the individual studies have been appraised all included studies and articles will be evaluated together to determine the Grade for the Body of Evidence. Based on the critically appraised evidence, clinical experience, patient/family values and preferences, and other Dimensions of care, the Strength of the Recommendation will be determined by considered judgment of the clinical teams, through a consensus process, weighing how much each dimension influences the recommendation strength.
- Evaluating the Evidence Algorithm
- Evidence Appraisal Forms (See below)
- Table of Evidence Levels
- Grading a Body of Evidence
- Judging the Strength of a Recommendation
- LEGEND Glossary
Evidence Appraisal Forms by Domain of Clinical Question
Intervention (including Treatment, Therapy, Prevention, Harm, and Quality Improvement)
- Systematic Review or Meta-Analysis
- Randomized Controlled Trial (RCT) or Controlled Clinical Trial (CCT)
- Cohort – Prospective or Retrospective
- Case–Control
- Longitudinal
- Cross–Sectional
- Quality Improvement
Diagnosis / Assessment
- Systematic Review or Meta-Analysis
- Controlled Clinical Trial (CCT)
- Psychometric Study
- Cohort - Prospective or Retrospective
- Cross-Sectional
Prognosis
- Systematic Review or Meta-Analysis
- Cohort - Prospective or Retrospective
- Case-Control
- Cross-Sectional
Etiology / Risk Factors
- Systematic Review or Meta-Analysis
- Randomized Controlled Trial (RCT) or Controlled Clinical Trial (CCT)
- Cohort - Prospective or Retrospective
- Case-Control
- Cross-Sectional
Incidence
Prevalence
Meaning / KAB* (Knowledge, Attitudes, Beliefs)
Any Domain
- Bench
- Case Reports or N-of-1
- Decision Analysis, Economic Analysis, Computer Simulation
- Descriptive, Epidemiology, Case Series
- Expert Opinion
- Guideline
- Mixed Methods
Intervention includes Treatment, Therapy, Prevention, Harm, and Quality Improvement
CCT= Controlled Clinical Trial; KAB= Knowledge, Attitudes, and Beliefs; RCT= Randomized Controlled Trial
Contact Us
For information, feedback or questions about our evidence-based decision making documents, email EBDMinfo@cchmc.org.
