Which of the following study designs provides the HIGHEST level of evidence in the hierarchy of evidence-based medicine?

• A Well-conducted randomised controlled trial
• B Prospective cohort study with long follow-up
• C Case-control study with nested design
• D Systematic review with meta-analysis of homogeneous RCTs ✓

Explanation

Systematic reviews with meta-analysis of multiple homogeneous RCTs represent the highest level (Level Ia) in the hierarchy of evidence according to both Oxford CEBM and GRADE frameworks. A single well-conducted RCT is Level Ib; prospective cohort studies are Level IIb; and nested case-control studies are intermediate. The superiority of systematic reviews lies in their comprehensive search, pooled estimates, and minimisation of random error through increased statistical power.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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