Johns Hopkins Nursing Evidence-Based Practice
Johns Hopkins Nursing Evidence-Based Practice
Appendix G: Individual Evidence Summary Tool
EBP Question:
Date:
Struggling to Meet Your Deadline?
Get your assignment on Johns Hopkins Nursing Evidence-Based Practice done on time by medical experts. Don’t wait – ORDER NOW!
Meet my deadline
Article
#
Author & Date
Evidence Type
Sample, Sample Size & Setting
Study findings that help answer the EBP question
Limitations
Evidence Level & Quality
Attach a reference list with full citations of articles reviewed for this EBP question.
Johns Hopkins Nursing Evidence-Based Practice
Appendix G: Individual Evidence Summary Tool
Directions for Use of the Individual Evidence Summary Tool
Purpose: This form is used to document the results of evidence appraisal in preparation for evidence synthesis. It provides the EBP team with documentation of the sources of evidence used, the year the evidence was published or otherwise communicated, the information gathered from each evidence source that helps the team answer the EBP question, and the level and quality of each source of evidence.
Header: Record the EBP question and date of the EBP project for reference.
Article #: Assign a number to each reviewed source of evidence. This organizes the Individual Evidence Summary and provides an easy way to reference articles.
Author and Date: Indicate the last name of first author, or the evidence source and the publication/communication date. It is important to list both author/evidence source and date because several documents may be from the same source.
Evidence Type: Indicate the type of evidence reviewed (example: RCT, meta-analysis, qualitative, systematic review, case study, narrative literature review).
Sample, Sample Size, and Setting: This is only applicable for evidence levels I, II, III, and level V quality improvement, financial or program evaluation. Provides a quick view of the population, number of participants, and where the study took place.
Study findings that help answer the EBP question: Although there may be many points of interest to the reviewer, list only findings that directly apply to the EBP question.
Limitations: Include information that may or may not be within the text of the article regarding drawbacks of the piece of evidence. The evidence may list limitations, or it may be evident to you as you review the evidence that an important point is missed, or the sample does not apply to the population of interest.
Evidence Level and Quality: Using information from the individual appraisal tools, transfer the evidence level and quality rating into this column.
Johns Hopkins Nursing Evidence-Based Practice
Appendix E: Research Evidence Appraisal Tool
Evidence Level and Quality:_______________________
Article Title:
Number:
Author(s):
Publication Date:
Journal:
Setting:
Sample
(Composition & size):
Does this evidence address my EBP question?
£Yes
£No
Do not proceed with appraisal of this evidence
Level of Evidence (Study Design)
A. Is this a report of a single research study? If No, go to B.
1. Was there manipulation of an independent variable?
Was there a control group?
Were study participants randomly assigned to the intervention and control groups?
If Yes to all three, this is a Randomized Controlled Trial (RCT) or Experimental Study
If Yes to #1 and #2 and No to #3, OR Yes to #1 and No to #2 and #3, this is Quasi Experimental (some degree of investigator control, some manipulation of
an independent variable, lacks random assignment to groups, may have a control group)
If No to #1, #2, and #3, this is Non-Experimental (no manipulation of independent variable, can be descriptive, comparative, or correlational, often uses secondary data) or Qualitative (exploratory in nature such as interviews or focus groups, a starting point for studies for which little research currently exists, has small sample sizes, may use results to design empirical studies)
NEXT, complete THE bOTTOM SECTION ON THE Following PAGE, “STUDY FINDINGS THAT HELP YOU ANSWER THE EBP QUESTION”
£ LEVEL I
£ LEVEL II
£ LEVEL III
£Yes
£Yes
£Yes
£Yes
£No
£No
£No
£No
B. Is this a summary of multiple research studies? If No, go to Non-Research Evidence Appraisal Form.
1. Does it employ a comprehensive search strategy and rigorous appraisal method (Systematic Review)? If No, use Non-Research Evidence Appraisal Tool; if Yes:
a. Does it combine and analyze results from the studies to generate a new statistic (effect size)? (Systematic review with meta-analysis)
b. Does it analyze and synthesize concepts from qualitative studies? (Systematic review with meta-synthesis
If Yes to either a or b, go to #2B below.
2. For Systematic Reviews and Systematic Reviews with meta-analysis or meta-synthesis:
a. Are all studies included RCTs?
b. Are the studies a combination of RCTs and quasi-experimental or
quasi-experimental only?
c. Are the studies a combination of RCTs, quasi-experimental and
non-experimental or non-experimental only?
d. Are any or all of the included studies qualitative?
complete THE NEXT SECTION, “STUDY FINDINGS THAT HELP YOUANSWER THE EBP QUESTION”
£ LEVEL I
£ LEVEL II
£ LEVEL IIl
£ LEVEL IIl
£Yes
£Yes
£Yes
£Yes
£No
£No
£No
£No
Study findings that help you answer the EBP question:
NOW COMPLETE THE FOLLOWING PAGE, “QUALITY APPRAISAL OF RESEARCH STUDIES”, AND ASSIGN A QUALITY SCORE TO YOUR ARTICLE
Quality Appraisal of Research Studies
Does the researcher identify what is known and not known about the problem and how the study will address any gaps in knowledge?
· Was the purpose of the study clearly presented?
· Was the literature review current (most sources within last 5 years or classic)?
· Was sample size sufficient based on study design and rationale?
· If there is a control group:
o Were the characteristics and/or demographics similar in both the control and intervention groups?
o If multiple settings were used, were the settings similar?
o Were all groups equally treated except for the intervention group(s)?
· Are data collection methods described clearly?
· Were the instruments reliable (Cronbach’s α [alpha] > 0.70)?
· Was instrument validity discussed?
· If surveys/questionnaires were used, was the response rate > 25%?
· Were the results presented clearly?
· If tables were presented, was the narrative consistent with the table content?
· Were study limitations identified and addressed?
· Were conclusions based on results?
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£No
£No
£No
£No
£No
£No
£No
£No
£No
£No
£No
£No
£No
£No
£No
£NA
£NA
£NA
£NA
£NA
£NA
£NA
Quality Appraisal of Systematic Review with or without Meta-Analysis or Meta-Synthesis
· Was the purpose of the systematic review clearly stated?
· Were reports comprehensive, with reproducible search strategy?
o Key search terms stated
o Multiple databases searched and identified
o Inclusion and exclusion criteria stated
· Was there a flow diagram showing the number of studies eliminated at each level of review?
· Were details of included studies presented (design, sample, methods, results, outcomes, strengths and limitations)?
· Were methods for appraising the strength of evidence (level and quality) described?
· Were conclusions based on results?
o Results were interpreted
o Conclusions flowed logically from the interpretation and systematic review question
· Did the systematic review include both a section addressing limitations and how they were addressed?
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£No
£No
£No
£No
£No
£No
£No
£No
£No
£No
£No
£No
Quality Rating Based on quality appraisal
A High quality: consistent, generalizable results; sufficient sample size for the study design; adequate control; definitive conclusions; consistent recommendations based on comprehensive literature review that includes thorough reference to scientific evidence
B Good quality: reasonably consistent results; sufficient sample size for the study design; some control, and fairly definitive conclusions; reasonably consistent recommendations based on fairly comprehensive literature review that includes some reference to scientific evidence
C Low quality or major flaws: little evidence with inconsistent results; insufficient sample size for the study design; conclusions cannot be drawn
Johns Hopkins Nursing Evidence-Based Practice
Appendix F: Non-Research Evidence Appraisal Tool
Evidence Level & Quality:________________________
Article Title:
Number:
Author(s):
Publication Date:
Journal:
Does this evidence address the EBP question?
£Yes
£No
Do not proceed with appraisal of this evidence
Clinical Practice Guidelines: Systematically developed recommendations from nationally recognized experts based on research evidence or expert consensus panel. LEVEL IV
Consensus or Position Statement: Systematically developed recommendations based on research and nationally recognized expert opinion that guides members of a professional organization in decision-making for an issue of concern. LEVEL IV
· Are the types of evidence included identified?
· Were appropriate stakeholders involved in the development of recommendations?
· Are groups to which recommendations apply and do not apply clearly stated?
· Have potential biases been eliminated?
· Were recommendations valid (reproducible search, expert consensus, independent review, current, and level of supporting evidence identified for each recommendation)?
· Were the recommendations supported by evidence?
· Are recommendations clear?
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£No
£No
£No
£No
£No
£No
£No
Literature Review: Summary of published literature without systematic appraisal of evidence quality or strength. LEVEL V
Is subject matter to be reviewed clearly stated?
· Is relevant, up-to-date literature included in the review (most sources within
last 5 years or classic)?
· Is there a meaningful analysis of the conclusions in the literature?
· Are gaps in the literature identified?
· Are recommendations made for future practice or study?
£Yes
£Yes
£Yes
£Yes
£Yes
£No
£No
£No
£No
£No
Expert Opinion: Opinion of one or more individuals based on clinical expertise. LEVEL V
· Has the individual published or presented on the topic?
· Is author’s opinion based on scientific evidence?
· Is the author’s opinion clearly stated?
· Are potential biases acknowledged?
£Yes
£Yes
£Yes
£Yes
£No
£No
£No
£No
Organizational Experience:
Quality Improvement: Cyclical method to examine organization-specific processes at the local level. LEVEL V
Financial Evaluation: Economic evaluation that applies analytic techniques to identify, measure, and compare the cost and outcomes of two or more alternative programs or interventions. LEVEL V
Program Evaluation: Systematic assessment of the processes and/or outcomes of a program and can involve both quantitative and qualitative methods. LEVEL V
Setting:
Sample (composition/size):
· Was the aim of the project clearly stated?
· Was the method adequately described?
· Were process or outcome measures identified?
· Were results adequately described?
· Was interpretation clear and appropriate?
· Are components of cost/benefit analysis described?
£Yes
£Yes
£Yes
£Yes
£Yes
£Yes
£No
£No
£No
£No
£No
£No £N/A
Case Report: In-depth look at a person, group, or other social unit. LEVEL V
· Is the purpose of the case report clearly stated?
· Is the case report clearly presented?
· Are the findings of the case report supported by relevant theory or research?
· Are the recommendations clearly stated and linked to the findings?
£Yes
£Yes
£Yes
£Yes
£No
£No
£No
£No
Community Standard, Clinician Experience, or Consumer Preference
Community Standard: Current practice for comparable settings in the community LEVEL V
Clinician Experience: Knowledge gained through practice experience LEVEL V
Consumer Preference: Knowledge gained through life experience LEVEL V
Information Source(s):
Number of Sources:
· Source of information has credible experience.
· Opinions are clearly stated.
· Identified practices are consistent.
£Yes
£Yes
£Yes
£No
£No £N/A
£No £N/A
Findings that help you answer the EBP question:
Quality Rating for Clinical Practice Guidelines, Consensus or Position Statements (Level IV)
A High quality: Material officially sponsored by a professional, public, private organization, or government agency; documentation of a systematic literature search strategy; consistent results with sufficient numbers of well-designed studies; criteria-based evaluation of overall scientific strength and quality of included studies and definitive conclusions; national expertise is clearly evident; developed or revised within the last 5 years.
B Good quality: Material officially sponsored by a professional, public, private organization, or government agency; reasonably thorough and appropriate systematic literature search strategy; reasonably consistent results, sufficient numbers of well-designed studies; evaluation of strengths and limitations of included studies with fairly definitive conclusions; national expertise is clearly evident; developed or revised within the last 5 years.
C Low quality or major flaws: Material not sponsored by an official organization or agency; undefined, poorly defined, or limited literature search strategy; no evaluation of strengths and limitations of included studies, insufficient evidence with inconsistent results, conclusions cannot be drawn; not revised within the last 5 years.
Quality Rating for Organizational Experience (Level V)
A High quality: Clear aims and objectives; consistent results across multiple settings; formal quality improvement or financial evaluation methods used; definitive conclusions; consistent recommendations with thorough reference to scientific evidence
B Good quality: Clear aims and objectives; formal quality improvement or financial evaluation methods used; consistent results in a single setting; reasonably consistent recommendations with some reference to scientific evidence
C Low quality or major flaws: Unclear or missing aims and objectives; inconsistent results; poorly defined quality improvement/financial analysis method; recommendations cannot be made
Quality Rating For Literature Review, Expert Opinion, Community Standard, Clinician Experience, Consumer Preference (Level V)
A High quality: Expertise is clearly evident; draws definitive conclusions; provides scientific rationale; thought leader in the field
B Good quality: Expertise appears to be credible; draws fairly definitive conclusions; provides logical argument for opinions
C Low quality or major flaws: Expertise is not discernable or is dubious; conclusions cannot be drawn
