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In page Hierarchy of evidence:

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A large number of hierarchies of evidence have been proposed. Similar protocols for evaluation of research quality are still in development. So far, the available protocols pay relatively little attention to whether outcome research is relevant to efficacy (the outcome of a treatment performed under ideal conditions) or to effectiveness (the outcome of the treatment performed under ordinary, expectable conditions).[citation needed] In 2025 Francis PT suggested that the Hierarchy of evidence pyramid for Therapeutic studies and Etiological studies be shown separately as they follow separate paths.[3]