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    what type of research evidence should an evidence-based protocol work group look for first?

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    Levels of Evidence

    Understanding types of resources

    Krueger LibraryResearch HubResearch Start GuidesEvidence Based Practice ToolkitLevels of Evidence

    Evidence Based Practice Toolkit

    What is EBP?

    Asking Your Question

    Levels of Evidence

    Levels of Evidence Table

    Evidence Pyramid (Levels of Evidence)

    Evidence Appraisal Find Research

    Standards of Practice

    Levels of Evidence Table

    Levels of evidence (sometimes called hierarchy of evidence) are assigned to studies based on the methodological quality of their design, validity, and applicability to patient care. These decisions gives the "grade (or strength) of recommendation."

    Level of evidence (LOE)Description

    Level I

    Evidence from a systematic review or meta-analysis of all relevant RCTs (randomized controlled trial) or evidence-based clinical practice guidelines based on systematic reviews of RCTs or three or more RCTs of good quality that have similar results.

    Level II

    Evidence obtained from at least one well-designed RCT (e.g. large multi-site RCT).

    Level III

    Evidence obtained from well-designed controlled trials without randomization (i.e. quasi-experimental).

    Level IV

    Evidence from well-designed case-control or cohort studies.

    Level V

    Evidence from systematic reviews of descriptive and qualitative studies (meta-synthesis).

    Level VI

    Evidence from a single descriptive or qualitative study.

    Level VII

    Evidence from the opinion of authorities and/or reports of expert committees.

    This level of effectiveness rating scheme is based on the following: Ackley, B. J., Swan, B. A., Ladwig, G., & Tucker, S. (2008). (p. 7)St. Louis, MO: Mosby Elsevier.

    Different types of clinical questions are best answered by different types of research studies.  You might not always find the highest level of evidence (i.e., systematic review or meta-analysis) to answer your question. When this happens, work your way down to the next highest level of evidence.

    This table suggests study designs best suited to answer each type of clinical question.

    Clinical QuestionSuggested Research Design(s)

    All Clinical Questions

    Systematic review, meta-analysis

    Therapy

    Randomized controlled trial (RCT), meta-analysis

    Also: cohort study, case-control study, case series

    Etiology

    Randomized controlled trial (RCT), meta-analysis, cohort study

    Also: case-control study, case series

    Diagnosis

    Randomized controlled trial (RCT)

    Also: cohort study Prevention

    Randomized controlled trial (RCT), meta-analysis

    Also: prospective study, cohort study, case-control study, case series

    Prognosis Cohort study

    Also: case-control study, case series

    Meaning Qualitative study Quality Improvement

    Randomized controlled trial (RCT)

    Also: qualitative study

    Cost Economic evaluation

    Evidence Pyramid (Levels of Evidence)

    "Evidence Pyramid" is a product of Tufts University and is licensed under BY-NC-SA license 4.0

    << Previous: Asking Your QuestionNext: Evidence Appraisal >>

    Last Updated: Feb 4, 2022 8:59 AM

    URL: https://libguides.winona.edu/ebptoolkit

    Print Page Login to LibApps Report a problem. Subjects: Nursing

    Tags: EBP, medical, NURS, nursing, PICO, systematic reviews

    Source : libguides.winona.edu

    Introduction

    This guide includes a tutorial about Evidence-Based Practice (EBP) in Health, a Reference Shelf of supporting eBooks, and a Toolkit of online sources of evidence.

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    Evidence-Based Practice in Health

    This guide includes a tutorial about Evidence-Based Practice (EBP) in Health, a Reference Shelf of supporting eBooks, and a Toolkit of online sources of evidence.

    Introduction

    Introduction: About this Guide

    What is Evidence-Based Practice

    References Module 1: Ask

    PICO Framework and the Question Statement

    Types of Clinical Question

    Hierarchy of Evidence

    Module 2: Acquire

    Selecting a Resource

    Searching PubMed Module 3: Appraise Module 4: Apply Module 5: Audit Reference Shelf

    Evidence-Based Practice in Health by Murray Turner at University of Canberra is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

    How to cite this Guide:

    Turner, M. (2014). "Evidence-Based Practice in Health.” Retrieved from University of Canberra website:  https://canberra.libguides.com/evidence

    Read more about Evidence-Based Medicine

    Supporting your practice: Evidence-Based Medicine.  By Dr Mary Bushell MPS.6  Read this article and you should be able to:

    Define Evidence-Based Medicine (EBM)

    Explain different study designs and the level of evidence they generate

    Explain the significance of probability (p) values, confidence intervals (CI), relative risk (RR), odds ratios (OR), hazard ratios (HR), and number-needed-to-treat (NNT)

    Discuss the importance of EBM for healthcare professionals.

    Introduction: About this Guide

    This guide includes a tutorial about Evidence-Based Practice (EBP) in Health, a Reference Shelf of supporting eBooks, and a Toolkit of online sources of evidence.

    Tutorial

    The goals of the tutorial are to clearly outline the theory of EBP and to explain how that theory can be put to practice in the day-to-day work of caring for patients.   The tutorial includes an introduction and modules that follow the "5A's Cycle" of EBP that include assessing the patient and prioritizing questions about his/her care, asking a focused clinical question, acquiring the evidence to answer the question, appraising the research, applying the research findings to patient care, and finally auditing your performance.. The cycle begins again with an assessment of the patient and the patient's care.1

    The tutorial focuses largely on efficient literature searching and therefore on asking questions and acquiring the best evidence.  In particular, it suggests specific strategies for finding evidence from primary studies, systematic reviews and meta-analyses using EBP tools.  Appraisal is also touched upon, with suggestions for scanning search results to identify articles more likely to yield robust, applicable evidence.

    At the end of the tutorial, you should be able to:

    Formulate a clinical question using the PICO framework;

    Identify five common categories of clinical questions;

    Identify which research methodologies provide the best evidence for your question type;

    Distinguish between systematic reviews, meta-analyses and narrative or clinical topic reviews;

    Search Medline/PubMed effectively for studies likely to provide the current best evidence by

    Identifying appropriate search terms, including Medical Subject Headings (MeSH) terms; and

    Employ evidence filters such as PubMed's Clinical Queries;

    Identify articles from your PubMed search results that are most likely to provide current, valid, reliable and relevant evidence to answer your question.

    This tutorial assumes you already have some familiarity with basic and advanced PubMed search techniques, as well as with MeSH searching.

    There are many excellent on-line and print guides that address the critical appraisal of a research report and the application of evidence to an individual patient's care. You will find links to selected resources that provide especially rich content in these areas in the Appraise and Apply modules of this tutorial.

    It is best to work systematically through the various modules, starting with Introduction: About Evidence-Based Practice, and then the five modules.

    Reference Shelf of EBP eBooks and Books

    The Library has a vast range of books and ebooks about EBP that can be found via Library Search (the Library Catalogue).  The Reference Shelf in this guide lists a range of the EBP eBooks and Books by category and discipline area.

    What is Evidence-Based Practice

    What is Evidence-Based Practice?

    The classic definition of Evidence-Based Practice (EBP) is from Dr David Sackett. EBP is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research”.2

    Source : canberra.libguides.com

    research quiz 3 questions Flashcards

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    research quiz 3 questions

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    PICOTS format is most useful for focusing what kind of clinical question for an EBP project

    A. Question about intervention effectiveness

    B. Study of risk factors for a clinical condition

    C. Quality study

    D. Question about the meaning of a process of care

    Click card to see definition 👆

    A. Question about intervention effectiveness

    Click again to see term 👆

    How are conclusions of a systematic review reached

    A. By statistically combining findings from individual studies

    B. By cross-study comparisons and logical reasoning

    C. By focusing on the findings of large studies

    D. By polling experts in the field

    Click card to see definition 👆

    B. By cross-study comparisons and logical reasoning

    Click again to see term 👆

    1/15 Created by marisascampoli

    Terms in this set (15)

    PICOTS format is most useful for focusing what kind of clinical question for an EBP project

    A. Question about intervention effectiveness

    B. Study of risk factors for a clinical condition

    C. Quality study

    D. Question about the meaning of a process of care

    A. Question about intervention effectiveness

    How are conclusions of a systematic review reached

    A. By statistically combining findings from individual studies

    B. By cross-study comparisons and logical reasoning

    C. By focusing on the findings of large studies

    D. By polling experts in the field

    B. By cross-study comparisons and logical reasoning

    Questions not easily answered by research

    A. New tech as when only manufacturers datas available

    B. Application of an existing intervention to population not yet studied

    C. Care of an individual pt who doesnt want a standardized intervention

    D. Moral or ethical course of action

    E. None of these, all could be answered by research evidence

    F. All of the above F. All of the above

    Which aspect of appraisal of systematic review is the following question a part of? How were potential individual research reports identified

    A. Synopsis

    B. Clinical significance

    C. Applicability D. Credibility A. Synopsis

    Which isnt a major determinant of credibility of a conclusion of a systematic review

    A. # of studies w similar findings

    B. Journal in which the IRR was published

    C. Quality of studies addressing the issues

    D. Quality of synthesis across studies

    B. Journal in which the IRR was published

    In evaluating the applicability of the findings of a systematic review, which of the following is a major determinant

    A. Whether only high-quality studies were included

    B. Whether a comprehensive search for study reports was conducted

    C. Whether the patient samples in the studies were similar to the setting

    D. Whether objectives of review were clear

    C. Whether the patient samples in the studies were similar to the setting

    Which of the following isnt a trigger for an EBP project

    A. An adverse pt event

    B. Family disagreement about continuing life support of elderly pt

    C. Pt dissatisfication with care

    D. Quality data indicating less than ideal pt outcomes

    B. Family disagreement about continuing life support of elderly pt

    Which of the following is NOT a criterion that should be used when appraising the credibility of the conclusions of a SR

    A. A comprehensive search was conducted

    B. Explicit criteria were used for study inclusion and exclusion

    C. Findings are consistent across several studies

    D. The reviewer has conducted a prior study about the question or topic

    D. The reviewer has conducted a prior study about the question or topic

    The decision regarding whether the conclusions of a systematic review are applicable to your nursing practice is determined by

    A. The credentials of the persons performing the review

    B. The use of only randomized clinical trials in the review

    C. Whether the included studies were of several different populations

    D. The setting and patients included in the original studies included in the review

    D. The setting and patients included in the original studies included in the review

    What is your review of this question that served as a project guide

    Would recommending the shingles vaccine to all pt >65 who are seen in our medical clinics reduce the incidence of shingles over their lifetime?

    A. Too vague

    B. Missing essential elements for focused project

    C. Include all essential elements for focused project

    D. Too specific

    C. Include all essential elements for focused project

    Which of the following questions is part of appraising the credibility of a SR

    A. Was the search for study reports comprehensive and unbiased?

    B. Are there any reasons why conclusions might not apply to your setting?

    C. Is the size of the clinical effect large enough to make a difference in pt well being

    D. What topic or question did the SR address

    A. Was the search for study reports comprehensive and unbiased?

    What is min # of studies for a SR

    A. 5 B. 10 C. 30 D. 2 D.2

    When searching pub med what is the main advantage of using MeSH terms?

    A. Using them allows you to use the Boolean operators of AND, OR, NOT

    Source : quizlet.com

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