Conclusions
We provide the first empirical support for a foundational principle of EBM showing that low-quality evidence changes more often than high CoE. However, the effect size was not different between studies with low vs high CoE. The finding that the effect size did not differ between low and high CoE indicate urgent need to refine current EBM critical appraisal methods.
Key words: evidence-based medicine- critical appraisal-bias- random error- randomized trials - observational studies- systematic review- meta-epidemiology