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Reply to ‘Shaneyfelt T. Pyramids are guides not rules: the evolution of the evidence pyramid. Evid Based Med 2016;21:121–2’
  1. Brian S Alper1,2,
  2. R Brian Haynes3
  1. 1DynaMed, EBSCO Health, Ipswich, Massachusetts, USA
  2. 2University of Missouri, Columbia, Missouri, USA
  3. 3McMaster University, Hamilton, Ontario, Canada
  1. Correspondence to: Dr Brian S Alper
    , DynaMed, EBSCO Health, 10 Estes Street, Ipswich, MA 01938, USA; balper{at}

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We compliment Dr Shaneyfelt1 on recognising the EBHC pyramid 5.02 as a useful framework to guide the search for answers to clinical questions, especially at the point of care where time is more limited, and for suggesting use of the hierarchy of resources as a guide for searching and as an organisational scheme for evidence resources, and not as explicit rules for defining the evidence to use for a given question.

We agree that within a given …

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  • Twitter Follow Brian Alper at @BrianAlperMD

  • Competing interests BSA is the founding editor of DynaMed and an employee of its publisher, EBSCO and seeks collaboration with multiple entities which produce products named in the original article. RBH is the founding editor of ACP Journal Club and an employee of McMaster University, which provides evidence services for a number of clinical knowledge resources including ACP Journal Club, ACP JournalWise, BMJ Best Practice, DynaMed, EBMeDS, EvidenceUpdates, ACCESSSS and MacPLUS Federated Search.

  • Provenance and peer review Not commissioned; internally peer reviewed.