Redefining the Hierarchy of Evidence in Medicine in the Era of the Next Generation Clinical Trials and Real World Evidence: A Critical Review and the Next Generation Hierarchy
Innovative evidence modalities—such as OMICS-guided clinical trials, causally interpretable meta-analyses (CMAs), and real-world evidence (RWE)—are increasingly recognized by leading professional organisations and regulatory authorities. A PubMed review revealed gaps in integrating these modalities into the current evidence hierarchies, underscoring the urgent need for a next-generation hierarchy that recognises modern science and regulatory standards. To address this, a new A+ level of evidence
Authors
- Arvind Vatkar (ORCID: https://orcid.org/0000-0002-1325-7257)
- Salvatore Lentini (ORCID: https://orcid.org/0000-0001-5340-2589)
- Riyad Bendardaf (ORCID: https://orcid.org/0000-0002-5158-4590)
- Tarek Momenah (ORCID: https://orcid.org/0000-0003-3403-5941)
- Mohamed Saad Ambarek
- Mario Petrou (ORCID: https://orcid.org/0000-0003-2273-266X)
- Reida El Oakley (ORCID: https://orcid.org/0000-0003-4101-8998)
- Murad Ghrew
- Jérôme Cau
- Carlos A. Mestres (ORCID: https://orcid.org/0000-0001-8148-9044)
- David M. Williams
- Adel Altawaty
- Adel I. El Taguri
- Abdelsalam H. Almatmed
- Khairya K. Elmuttardi
Institutions
- University of Central Florida (US)
- Swansea Bay University Health Board (GB)
- University of Tripoli (LY)
- University of the Free State (ZA)
- Mahatma Gandhi Memorial Medical College (IN)
- Harefield Hospital (GB)
- University of Manchester (GB)
- University of Sharjah (AE)
- Université de Poitiers (FR)
- University of Catania (IT)
- Libyan International Medical University (LY)
Publication Details
- Journal
- Journal of The Best Available Evidence in Medicine
- Published
- 2025-11-11
- DOI
- https://doi.org/10.63720/v1i2005
- Citations
- 1
- Primary Topic
- Meta-analysis and systematic reviews
- Type
- article
- Field-Weighted Citation Impact
- 1.40