LITERATURE REVIEW

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AppendixF_NonresearchEvidenceAppraisalGeraldine.docx

Johns Hopkins Evidence-Based Practice Model for Nursing and Healthcare Professionals

Nonresearch Evidence Appraisal Tool

Appendix F

Does this evidence answer the EBP question?

☐Yes  Continue appraisal

☐ No  STOP, do not continue evidence appraisal

Article Summary Information

Article Title:

Author(s):

Number:

Population, size, and setting: 

Publication date:

Complete after appraisal:

Evidence level and quality rating:

Study findings that help answer the EBP question:

Article Appraisal Workflow

Level

Is this evidence:

This is…

☐ A clinical practice guideline or a consensus/position statement?

Level IV evidence, go to Section I: Level IV Appraisal to determine quality

☐ A literature review or integrative review?

Level V evidence, go to Section II, A: Level V Appraisal to determine quality

☐ An expert opinion?

Level V evidence, go to Section II, B: Level V Appraisal to determine quality

☐ Case report?

Level V evidence, go to Section II, C: Level V Appraisal to determine quality

☐ An organizational experience (including quality improvement, financial or program evaluations)?

Level V evidence, go to Section II, D: Level V Appraisal to determine quality

☐ Community standard, clinician experience, or consumer preference?

Level V evidence, go to Section II, E: Level V Appraisal to determine quality

Section I: Level IV Appraisal

Select the type of Level IV evidence

☐ Clinical practice guidelines (systematically developed recommendations from nationally recognized experts based on research evidence or expert consensus panel)

☐ Consensus or position statement (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)

Quality

After selecting the type of Level IV evidence, determine the quality of evidence using the considerations below:

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 defined?

☐ Yes

☐ No

Does each recommendation have an identified level of evidence stated?

☐ Yes

☐ No

Are recommendations clear?

☐ Yes

☐ No

Circle the appropriate quality rating below:

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: 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.

Record findings that help answer the EBP question on page 1

Section II: Level V Appraisal

A Select the type of article: ☐ Integrative review (summary of research evidence and theoretical literature; analyzes, compares themes, notes gaps in the selected literature)

☐ Literature review (summary of selected published literature including scientific and nonscientific, such as reports of organizational experience and opinions of experts)

Quality

After selecting the type of Level V evidence, determine the quality of evidence using the considerations below:

Is the purpose of the review clearly stated?

☐ Yes

☐ No

Is literature relevant and up-to-date (most sources are within the past five years or classic)?

☐ Yes

☐ No

Are gaps in the literature identified?

☐ Yes

☐ No

Are recommendations made for future practice or study?

☐ Yes

☐ No

Additionally, for Integrative Reviews only:

Was the literature search strategy clearly described?

☐ Yes

☐ No

Was the literature appraised for strength and quality

☐ Yes

☐ No

Of the literature reviewed, is there a meaningful analysis of the conclusions across

the articles included in the review?

☐ Yes

☐ No

Circle the appropriate quality rating below:

Integrative Reviews:

A High quality: Subject matter is clearly defined, literature search strategies are clear and thorough, the authors undertook a meaningful analysis of included evidence, conclusions are clear, gaps and limitations thoroughly addressed

B Good quality: Subject matter is defined, literature search strategy reasonably clear with possible gaps, the author undertook a somewhat meaningful analysis of included evidence, fairly clear conclusions, gaps and limitations reasonably addressed

C Low quality: Subject matter not clearly defined, literature search strategy lacking transparency or thoroughness, lack of meaningful analysis of included evidence, conclusions cannot be drawn, limitations not addressed

Literature Reviews:

A High quality: Subject matter is clearly defined, literature is up-to-date, gaps and limitations thoroughly addressed, recommendations for future practice or study are clearly identified

B Good quality: Subject matter is defined, literature is mostly up-to-date, gaps and limitations reasonably addressed, recommendations for future practice or study are identified

C Low quality: Subject matter not clearly defined, literature is out-of-date, gaps and limitations not addressed, recommendations are not provided

Record findings that help answer the EBP question on page 1

Section II: Level VAppraisal (continued)

B Select the type of article:

☐ Expert opinion (opinion of one or more individuals based on clinical expertise)

Quality

After selecting the type of Level V evidence, determine the quality of evidence using the considerations below:

Does the author have relevant education and training?

☐ Yes

☐ No

Do they have relevant professional and academic affiliations?

☐ Yes

☐ No

Have they previously been published in the area of interest?

☐ Yes

☐ No

Is there thorough citing of recent literature (within the past 5 years)?

☐ Yes

☐ No

Have they been recognized by state, regional, national, or international groups for their expertise?

☐ Yes

☐ No

Are their publications well-cited by others?

☐ Yes

☐ No

*A web search can provide information about expertise*

Circle the appropriate quality rating below:

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 a logical argument for opinions.

C Low quality: Expertise is not discernable or is dubious; conclusions cannot be drawn.

Record findings that help answer the EBP question on page 1

Section II: Level V Appraisal (continued)

C Select the type of article:

☐ Case report (an in-depth look at a person or group or another social unit)

Quality

After selecting the type of Level V evidence, determine the quality of evidence using the considerations below:

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

Circle the appropriate quality rating below:

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 a logical argument for opinions.

C Low quality: Expertise is not discernable or is dubious; conclusions cannot be drawn.

Record findings that help answer the EBP question on page 1

Section II: Level V Appraisal (continued)

D Select the type of article:

☐ Quality improvement (cyclical method to examine workflows, processes, or systems within a specific organization)

☐ 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)

☐ Program evaluation (systematic assessment of the processes and/or outcomes of a program; can involve both quaNtitative and quaLitative methods)

Quality

After selecting the type of Level V evidence, determine the quality of evidence using the considerations below:

Was the aim of the project clearly stated?

☐ Yes

☐ No

Was a formal QI method used for conducting or reporting the project (e.g., PDSA, SQUIRE 2.0)?

☐ Yes

☐ No

Was the method fully described?

☐ Yes

☐ No

Were process or outcome measures identified?

☐ Yes

☐ No

Were results fully described?

☐ Yes

☐ No

Was the interpretation clear and appropriate?

☐ Yes

☐ No

Are components of cost/benefit or cost-effectiveness data described?

☐ Yes

☐ No

☐ N/A

Circle the appropriate quality rating below:

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: Unclear or missing aims and objectives; inconsistent results; poorly defined quality improvement/financial analysis method; recommendations cannot be made.

Record findings that help answer the EBP question on page 1

Section II: Level VAppraisal (continued)

E Select the type of article:

☐ Community standard (current practice for comparable settings in the community)

☐ Clinician experience (knowledge gained through practice experience from the clinician perspective)

☐ Consumer preference (knowledge gained through life experience from the patient's perspective)

Record the sources of information and the number of sources:

Quality

After selecting the type of Level V evidence, determine the quality of evidence using the considerations below:

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

Circle the appropriate quality rating below:

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 a logical argument for opinions.

C Low quality: Expertise is not discernable or is dubious; conclusions cannot be drawn.

Record findings that help answer the EBP question on page 1

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