Understanding levels of evidence for scientific communication.

Foot & Ankle Specialist (FAS) is adding a "level of evidence" rating to all new submissions. This is important as evidence-based medicine in practice is increasingly important. The rationale for adding this rating to FAS publications is multifaceted. It will encourage researchers to design better projects and become adept at critically evaluating research. It will put research publications into appropriate context, and it will guide the profession in general to a higher level of scientific analysis. Four types of studies will be used at FAS: therapeutic, prognostic, diagnostic, and economic/decision making. Within each of these types of studies, levels of evidence between I and V can be assigned. A description of each type and explanation of how to assign evidence level is given. This may assist authors and readers as they work to design projects and critically evaluate literature.