Evidence level and quality rating

Evidence level and quality rating:

 

 

 

Article title: Number:
Author(s): Publication date:
Journal:
Setting: Sample (composition and size):
Does this evidence address my EBP question?

Yes

No- Do not proceed with appraisal of this evidence

 

· Clinical Practice Guidelines LEVEL IV

Systematically developed recommendations from nationally recognized experts based on research evidence or expert consensus panel

· Consensus or Position Statement LEVEL IV

Systematically developed recommendations, based on research and nationally recognized expert opinion, that guide members of a professional organization in decision-making for an issue of concern

· Are the types of evidence included identified? · Yes · No
· Were appropriate stakeholders involved in the development of recommendations? · Yes · No
· Are groups to which recommendations apply and do not apply clearly stated? · Yes · No
· Have potential biases been eliminated? · Yes · No
· Does each recommendation have an identified level of evidence stated? · Yes · No
· Are recommendations clear? · Yes · No
Findings That Help Answer the EBP Question
Complete the corresponding quality rating section.

 

 

 

 

 

 

Johns Hopkins Nursing Evidence-Based Practice

Appendix F: Non-Research Evidence Appraisal Tool

 

 

Johns Hopkins Nursing Evidence-Based Practice

Appendix F

Non-Research Evidence Appraisal

 

 

 

 

 

1

 

· Literature review LEVEL V

Summary of selected published literature including scientific and nonscientific such as reports of organizational experience and opinions of experts

· Integrative review LEVEL V

Summary of research evidence and theoretical literature; analyzes, compares themes, notes gaps in the selected literature

· Is subject matter to be reviewed clearly stated? · Yes · No
· Is literature relevant and up-to-date (most sources are within the past five years or classic)? · Yes · No
· Of the literature reviewed, is there a meaningful analysis of the conclusions across the articles included in the review? · Yes · No
· Are gaps in the literature identified? · Yes · No
· Are recommendations made for future practice or study? · Yes · No
Findings That Help Answer the EBP Question
Complete the corresponding quality rating section.

 

 

· Expert opinion LEVEL V

Opinion of one or more individuals based on clinical expertise

· Has the individual published or presented on the topic? · Yes · No
· Is the author’s opinion based on scientific evidence? · Yes · No
· Is the author’s opinion clearly stated? · Yes · No
· Are potential biases acknowledged? · Yes · No
Findings That Help Answer the EBP Question
Complete the corresponding quality rating section.

 

 

Organizational Experience

· Quality improvement LEVEL V

Cyclical method to examine workflows, processes, or systems with a specific organization

· Financial evaluation LEVEL V

Economic evaluation that applies analytic techniques to identify, measure, and compare the cost and outcomes of two or more alternative programs or interventions

· Program evaluation LEVEL V

Systematic assessment of the processes and/or outcomes of a program; can involve both quaNtitative and quaLitative methods

Setting: Sample Size/Composition:
· Was the aim of the project clearly stated? · Yes · No  
· Was the method fully described? · Yes · No  
· Were process or outcome measures identified? · Yes · No  
· Were results fully described? · Yes · No  
· Was interpretation clear and appropriate? · Yes · No  
· Are components of cost/benefit or cost effectiveness analysis described? · Yes · No · N/A
Findings That Help Answer the EBP Question
Complete the corresponding quality rating section.

 

 

 

 

 

 

· Case report LEVEL V

In-depth look at a person or group or another social unit

· Is the purpose of the case report clearly stated? · Yes · No
· Is the case report clearly presented? · Yes · No
· Are the findings of the case report supported by relevant theory or research? · Yes · No
· Are the recommendations clearly stated and linked to the findings? · Yes · No
Findings That Help Answer the EBP Question
Complete the corresponding quality rating.

 

 

 

 

 

 

Community standard, clinician experience, or consumer preference LEVEL V

· Community standard: Current practice for comparable settings in the community

· Clinician experience: Knowledge gained through practice experience

· Consumer preference: Knowledge gained through life experience

Information Source(s) Number of Sources
· Source of information has credible experience · Yes · No · N/A
· Opinions are clearly stated · Yes · No · N/A
· Evidence obtained is consistent · Yes · No · N/A
Findings That Help You Answer the EBP Question
Complete the corresponding quality rating section.

 

 

 

Quality Rating for Clinical Practice Guidelines, Consensus, or Position Statements (Level IV)
A High quality

Material officially sponsored by a professional, public, or private organization or a 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 clearly evident; developed or revised within the past five years.

B Good quality

Material officially sponsored by a professional, public, or private organization or a 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 clearly evident; developed or revised within the past five years.

C Low quality or major flaw

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 past five 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 Case Report, Integrative Review, Literature Review, Expert Opinion, Community Standard, Clinician Experience, Consumer Preference (Level V)
A High quality

Expertise is clearly evident, draws definitive conclusions, and provides scientific rationale; thought leader in the field.

B Good quality

Expertise appears to be credible, draws fairly definitive conclusions, and provides logical argument for opinions.

C Low quality or major flaws

Expertise is not discernable or is dubious; conclusions cannot be drawn.

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