Abstract
Hospital librarians seek information in an evidence-based way. After formulating a searchable, answerable foreground question, they seek literature as high as possible on an evidence pyramid of study types or publication types. The 6S pyramid of study types is the one most climbed today: studies (randomized, cohort, case-control) to synopses of studies to syntheses to synopses of syntheses to summaries to systems at the peak. For publication types, the pyramid with systematic reviews at its summit is preferred.