Assignment: Levels of Evidence
Assignment: Levels of Evidence
Assignment: Levels of Evidence
Week 2 discussion Search for Literature and Levels of Evidence Reflect on your practice, and identify a significant nursing clinical issue or change project that you would like to search for evidence in online sources. Formulate searchable, clinical questions in the PICO(T) format for your nursing clinical issue. Next, review the guidelines for the PICOT Assignment due Week 3. Use your PICOT elements to search for one report of a single, original study that has been published within the last 5 years from the CCN Library that is relevant to your nursing clinical issue. Briefly describe how it is relevant to your nursing clinical issue. Remember to give a complete reference to the study.
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When searching for evidence-based information, one should select the highest level of evidence possible–systematic reviews or meta-analyses. Systematic reviews, meta-analyses, and critically-appraised topics/articles have all gone through an evaluation process: they have been “filtered.” Information that has not been critically appraised is considered “unfiltered.”
As you move up the pyramid, however, fewer studies are available; it’s important to recognize that high levels of evidence may not exist for your clinical question. If this is the case, you’ll need to move down the pyramid if your quest for resources at the top of the pyramid is unsuccessful.
Meta-Analysis: A systematic review that uses quantitative methods to summarize the results.
Systematic Review: Authors have systematically searched for, appraised, and summarised all of the medical literature for a specific topic.
Critically Appraised Topic: Authors evaluate and synthesize multiple research studies.
Critically Appraised Articles: Authors evaluate and synopsize individual research studies.
Randomized Controlled Trials: Include a randomized group of patients in an experimental group and a control group. These groups are followed up for the variables/outcomes of interest.
Cohort Study: Identifies two groups (cohorts) of patients, one which did receive the exposure of interest, and one which did not, and following these cohorts forward for the outcome of interest.
Case-Control Study: Identifies patients who have the outcome of interest (cases) and control patients without the same outcome, and looks for exposure of interest.
Background Information/Expert Opinion: Handbooks, encyclopedias, and textbooks often provide a good foundation or introduction and often include generalized information about a condition. While background information presents a convenient summary, often it takes about three years for this type of literature to be published.
Animal Research/Lab Studies: Information begins at the bottom of the pyramid: this is where ideas and laboratory research takes place. Ideas turn into therapies and diagnostic tools, which then are tested with lab models and animals.
Use the TRIP database to find unfiltered and filtered information sources online.
Sources:
Greenhalgh, Trisha. How to Read a Paper: the Basics of Evidence Based Medicine. London: BMJ, 2000.
Glover, Jan; Izzo, David; Odato, Karen & Lei Wang. EBM Pyramid. Dartmouth University/Yale University. 2006.
Levels of Evidence
The following organizations describe levels of evidence:
