searching and appraising literature (Appendix G, E and F)

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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