Table 5.

Evidence Threshold Pathway Mapping

Is the question definitively addressable with RCTs?1 YES if: The outcome of interest would be measurable in < 5 years, subjects can ethically be randomized, a control group is plausible and ethical, blinding is potentially possible, a sample size of < 10,000 would provide adequate statistical power If YES, have RCTs been conducted?  ➔(1) If YES, then use GRADE2  ➔(2) If NO, then use an alternative tool, consider OCEBM3 NO if: A duration > 5 years adherence to the intervention is required, randomization is not plausible or ethical, exposure of interest is the cumulative, lifetime effect of health behaviors.  ➔ (3) Consider HEALM4

¹ RCTs: randomized controlled trials

² GRADE: Grading of Recommendations, Assessment, Development and Evaluation;

³ HEALM: Hierarchies of Evidence Applied to Lifestyle Medicine

⁴ OCEBM: Oxford Center for Evidence Based Medicine