You may have noticed that for a blog that is called “Evidence-Based Fitness”, that there is not one single mention or reference to the “Hierarchy of Evidence” pyramid. This is entirely intentional. I can’t count the number of blog drafts that I’ve tried to write and then scrapped on how much I hated the old “hierarchy of evidence”. But this week, the Evidence-Based Medicine “pyramid” has finally been reworked. It’s not as graphically pretty. It does, however, better reflect the reality of the “this is not actually how it works” pyramid of old. The new infographic was revealed and can be found here (it’s even open access!) So what does this new infographic mean?
In a nutshell, it means there are no more simple answers and no more simple classifications. It means you can’t skip steps. It hopefully means an end to the blind application of a clearly dysfunctional classification system to interpret and compare studies to one another.
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There’s a dark humour quote in surgery, “There is no surgery so simple that a resident can’t screw it up.” I’ve decided to make up an adage, “There is no concept or idea that the fitness/nutrition industry can’t corrupt,” because I never thought I would have to ever, ever, write a post like this.
It astonishes me that there is now a clear line in the sand between “evidence-based” trainers and non-“evidence-based” trainers. There’s even a third camp, which I’ll nick-name the “anti-evidence-based” trainers, where it’s not just a passive, I-don’t-really-read-much-research, but an active, I-explicitly-ignore-and-deride-research.
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