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Library Research Guides


Provides resources, strategies and information on conducting research in nursing.

Sources for Evidence Based Research

Integrated "5S" Levels of Organization of Evidence Pyramid

"5S" Levels of Organization of Evidence Pyramid

Modified from:  Haynes RB. Of studies, syntheses, synopses, summaries and systems: the “5S" evolution of services for evidence-based health care decisions. ACP J Club. 2006 Nov-Dec;145(3):A8-9. 


The Integrated "5S" Levels of Organization of Evidence Pyramid depicts the relationship between the Evidence Hierarchy (the small, inset pyramid) and the "5S" model. The Integrated Pyramid also includes foundational resources that do not have transparent evidence-based methodologies.

The Integrated Pyramid is labeled with resources available at the University of Michgian.


Summaries: Integrate the best available evidence from the lower layers to develop practice guildelines.


Synoposes: "Succinct descriptions "of an individual study or systematic review found in evidence-based abstraction journals


Syntheses: Systematic reviews which represent a "comprehensive summary of all research evidence related to a focused clinical question"


Studies: Source of original studies