Skip to Main Content  

Library Services for International Learners at UHN: Choosing a Resource

This guide will provide information on resources of relevance to international learners and provide an overview of evidence-based search techniques

Pyramid of Information Resources

The 6S Hierarchy below is meant to illustrate which types of resources/interfaces are the most efficient/effective for finding information to answer your clinical questions. Unlike pyramids based on levels of evidence, this one is ranked on the degree to which the information is critically pre-appraised. You would start out searching the most pre-processed information (where someone has already done the reading, critical appraisal, synthesizing, etc.), only moving towards original research as your question continues to go unanswered.  For a more detailed pyramid, including lists of resources that fall into the different levels, see the links below.

6S Hierarchy



1) Systems

Most compiled source of information where:

  • individual patient characteristics linked to current best evidence through electronic records
  • few and far between
  • often fall short in currency and evidence-base

eg) EPR, QuadraMed CPR, EPIC

2a) Summaries--Evidence-Based Textbooks

These are are good for:

  • background information
  • speedy answers

2b) Summaries--Guidelines

These are good for:

  • Finding recommended diagnostic and treatment methods from professional associations and influential institutions
  • Finding evidence based recommendations, depending on the method used to create the guideline

3) Synopses of Syntheses (Systematic Reviews)

These are good for getting the short version of a systematic review's findings along with a critical appraisal of their methods

4) Synopses (Systematic Reviews)

These are good for:

  • finding out what "the research" says as a whole
  • potentially finding more recent information than textbooks

5) Synopses of Studies

These are mostly the same resources as the Synopses of Synthesis but would provide a critical appraisal and summary of an individual study. To save time you may wish to search for synopsis of synthesis and synopsis of studies at the same time.

6) Studies

Use databases of indexed citations to find individual studies.

These are good for:

  • finding current/original research
  • finding non-Cochrane, non-Campbell systematic reviews
  • finding answers to obscure questions not addressed in systematic reviews or textbooks