The significance of defining the levels of medical evidence in medicolegal practice

Abstract

The practice of presenting a medical expert testimony to judges, juries and laymen could be improved by adopting the concept of ‘Levels of Medical Evidence’. Clinicians exchange the levels of evidence, between themselves, for valuing the significance of such evidence in matters of medical research, practice and guidelines. The expert witness has a duty to refer to both supportive and contradictive publications. S/he should provide an objective weighting of the publication, by referring to ‘the level of evidence’. Measuring the levels of medical evidence against a grid provide medical experts with an objective way of communication, for clarifying the relevance and quantifying its significance to a non-medical audience. The scarcity of some medical conditions, the rarity of their reporting in literature, and the conflict of medical consensus make the expert opinion of level four. The failure of a medical expert witness to explain where his/her opinion falls in the scale is a potential for misunderstanding, misrepresentation and misquotation.