Evidence Criteria

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A clinical decision rule is a clinical tool that quantifies various components of history, physical examination, and basic laboratory results move more efficiently toward the diagnosis, prognosis, or likely response to treatment in a patient. Many clinical decision rules exist, but some are more accurate and reliable than others. Three steps are involved in the development and testing of a rule: the creation of the rule premise, testing or validating the rule for accuracy, and assessing the impact of the rule on clinical behavior. Clinicians evaluating rules for clinical use should assess the following components: the method of derivation, validation of the rule to ensure that its repeated use leads to the same results; and it predictive power.

Level 1: Rules that can be used in a wide variety of settings with confidence that they can change clinician behavior and improve patient outcomes

Level 2: Rules that can be used in various settings with confidence in their accuracy.

Level 3: Rules that clinical may consider using with caution and only if patients in the study are similar to those in the clinician’s clinical setting.

Level 4: Rules that need further evaluation before they can be applied clinically