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Incomplete 6S pyramid displaying five of the six tiers with Summaries at the top Summaries are so-called 'textbook-like' resources that summarize the evidence found in the first four bottom tiers of the 6S Pyramid. As such, they provide a higher level of evidence than those resources below them.  

The Evidence

Summaries are probably your best bet for finding the highest levels of evidence for common disease topics as Systems are still evolving (we'll look at this in the Systems module next). However, for new clinical findings and rare cases, you probably will have to search down the pyramid to locate the evidence as either there is not yet enough evidence to warrant a summary or it is too new to have been critically appraised at the various levels.

Key Resources for Locating Summaries

Resources that fall into the Summaries category do not have particular search strategies as most feature a single Google-like search box. These are marketed and used as point-of-care resources and are, therefore, meant to be quick and easy to search. Each uses a grading system to evaluate the evidence. For example, UpToDate uses a modified version of GRADE.4

The two major summary resources are:

Clinical practice guidelines also fall into Summaries, however, we won't be covering any of those in this module. If you want to check them out for yourself, try National Guideline Clearinghouse or professional organization websites.

4Guyatt GH, Oxman AD, Vist GE et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008; 336:924-6.

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