| Level I | Good quality evidence |
Systematic review of RCTs with consistent findings High quality individual RCT |
| Level II |
Limited quality patient orientated evidence |
Systematic review of lower quality studies or studies with inconsistent findings Low quality clinical trial Cohort studies Case-control studies |
| Level III | Other |
Consensus guidelines, extrapolations from bench research, usual practice, opinion, disease-oriented evidence (intermediate or physiologic outcomes only), or case series |
[3] Sennosides A and B, oral AND lactulose: Librach SL, Bouvette M, De Angelis C, Farley J, Oneschuk D, Pereira JL, Syme A; Canadian Consensus Development Group for Constipation in Patients with Advanced Progressive Illness. Consensus recommendations for the management of constipation in patients with advanced, progressive illness. J Pain Symptom Manage. 2010 Nov;40(5):761-73. https://www.ncbi.nlm.nih.gov/pubmed/21075273
Sennosides A and B, oral AND lactulose: Candy B, Jones L, Larkin PJ, Vickerstaff V, Tookman A, Stone P. Laxatives for the management of constipation in people receiving palliative care. Cochrane Database Syst Rev. 2015 May 13;(5):CD003448. https://www.ncbi.nlm.nih.gov/pubmed/25967924