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Purpose of this Guide

Use this guide to find resources to support the Evidence-Informed Decision Making (EIDM) process. Databases are listed to the right according to the level of the 6S Pyramid that they represent.

When you are searching for resources to answer a quantitative (PICO) question, begin at the Summaries level of the pyramid and work your way down. Once you find an answer to your question, you don't typically need to continue to search lower levels of the pyramid.

When you are searching for resources to answer a qualitative (PS) question, begin at the Synopses of Single Studies level of the pyramid.

EIDM Video

Watch The Levels of the 6S Pyramid Explained video to learn about the levels of the 6S Pyramid and the types of resources found at each level.

Meta-Search Tools

Meta-Search tools search across all levels of the 6S Pyramid at the same time. Results are divided according to the level of the pyramid from which they come. There are advantages and disadvantages to these tools - their convenience makes them very appealing, but there are also some limitations: every database is set up slightly differently and uses different subject language, so a single search may miss a lot of content. Also, the Meta-Search tools don't search all of the 6S Pyramid resources available, so content may be missed. Experiment with them and see what you think...

Forming Foreground/Clinical Questions

For tips on constructing  foreground clinical questions - either quantitative or qualitative - consult the Forming Questions page on McMaster's Nursing guide.

EIDM Resources Available from the Conestoga Library

6S Pyramid

Image of the 6S pyramid with each level colour-coded - Systems:wine; Summaries: green; Synopses of Syntheses: purple; Syntheses: blue; Synopses of Single Studies: orange; Single Studies: red


Systems integrate information from the lower levels of the pyramid with individual patient records, producing a tailored recommendation for clinical decision-making. e.g. Computerized decision support systems (CDSSs)


Summaries look at all of the evidence from the lower levels of the pyramid, relying heavily on systematic reviews, where critical appraisal has already taken place. Recommendations for clinical practice are made based on the evidence, and each recommendation is graded according to the strength of the evidence.

Clinical Practice Guidelines

Please note: practice guidelines are sometimes published in journals, therefore you can also search journal databases (e.g. CINAHL, Medline, PubMed) to find guidelines, limiting your publication type to Practice Guidelines. Another resource for finding practice guidelines is the TRIP meta-search tool found on the left-hand side of the guide - be sure to limit your results to Guidelines because TRIP contains resources from all levels of the pyramid.

Evidence-Based Texts

Synopses of Syntheses

A synopsis of synthesis provides a summary of an individual systematic review. It must be a high quality review to meet all of the criteria to be selected for summary.

Evidence-Based Abstract Journals


Syntheses (Systematic Reviews)  involve a systematic approach in which extensive and thorough searches of the literature are conducted to locate all research studies that would answer a particular question, and then rigorous selection criteria are applied to ensure inclusion of only the best studies that demonstrate sound methodology, validity, etc. Critical appraisal of the studies is conducted by two or more reviewers independently.

The systematic review summarizes and synthesizes the evidence found in the selected studies.

Synopses of Single Studies / Evidence-Based Abstract Journals

A synopsis of a single study provides a summary of an individual primary research study. The research study must be of high quality and meet the necessary criteria to be selected for summary.

Single Studies

Single studies refer to primary, original research studies conducted to answer specific clinical questions.

CINAHL, Medline & PubMed all feature a filter for Clinical Queries which will limit your search results to clinically relevant and scientifically sound studies of the following types: Therapy, Prognosis, Review, Qualitative, and Causation (Etiology).