Abstract
Background and objective
The assessment of evidence in health research for interventions has traditionally relied on hierarchical models that prioritize randomized controlled trials and meta-analyses. Over time, alternative models have evolved, reshaping and rebalancing sources of evidence and giving more weight to external validity. This scoping review will systematically identify and map existing models of evidence assessment, including hierarchical, circular, matrix-based, and integrative approaches. It will examine how these models conceptualize and balance internal and external validity.Methods
Guided by the JBI Scoping Review Methodology and reported in accordance with the PRISMA-ScR framework, the review will include peer-reviewed literature and grey literature, with data extraction and synthesis conducted independently by two reviewers. A descriptive synthesis and framework matrix will be used to compare model structures, theoretical foundations, and applications.Conclusion
Findings from this review are intended to inform discussions on consensus-based, context-sensitive approaches to evidence appraisal and their potential implications for health technology assessment, guideline development, and clinical decision-making.Plain language summary
Researchers have traditionally judged the strength of health research by giving most weight to studies such as randomized controlled trials and meta-analyses. These approaches are useful for determining whether a treatment works under controlled conditions, but they may not always show how well the treatment works in real-world settings. Over time, different ways of assessing evidence have been developed. Some use a hierarchy, while others use circular, matrix-based, or combined approaches. These newer models may give more importance to external validity-how well research findings apply to real patients and everyday healthcare settings. This review will identify and compare different models used to assess evidence in health research from both published academic studies and other relevant sources like websites of guideline development organizations. The review will examine how each model is structured, the ideas behind it, and how it is used in practice. The findings may help researchers and healthcare decision-makers better understand how different types of evidence can be balanced, particularly when considering the context in which healthcare is delivered.