V Evidence (Based on experiential and non-research evidence) Case Reports Reports that describe the history of a single patient, or a group of patients, usually in the form of a story. Case Study An intensive investigation of a case involving a person or small group of persons, an issue or an event. Expert Opinion/ Manufacturer’s Recommendations Melnyk, B. & Fineout-Overholt,, E. (2011). Evidence-based practice in nursing and healthcare: A guide to best practice (2nd Ed.). Philadelphia: Lippincott Williams and Wilkins. Level of Type of Evidence Evidence Evidence from systematic review or meta-analysis of multiple controlled studies with results that Strongest consistently support a specific action, intervention or treatment I (A) Evidence from at least one well designed controlled study, randomized & non-randomized, with II (B) results that support a specific action, intervention or treatment Evidence from qualitative studies, descriptive or correlational studies, integrative reviews or III (C) randomized controlled trials with inconsistent results Evidence from peer reviewed professional organizational standards, with clinical evidence to support IV (D) recommendations; Includes non-experimental studies Evidence from theory based evidence from expert opinion or multiple case reports; Interpretation of V (E) non-research based information by experts Weakest VI (M) Manufacturers’ recommendations only Based on: AACN’s evidence-leveling system Armola, R.R., Bourgault, A.M., Halm, M.A., Board, R.M, Bucher, L, Harrington, L., Heafey, C… & Medina, J. (2009). Upgrading the American Association of Critical-Care Nurses’ evidence-leveling hierarchy. American Journal of Critical Care, 18, 405-40. Appendix B: Grading the Evidence Level of Quality Grading Guides Evidence A High quality: consistent results, sufficient sample size, adequate control, Level I and definitive conclusions; consistent recommendations on extensive literature review that includes thoughtful reference to scientific evidence. Level II
V Evidence (Based on experiential and non-research evidence) Case Reports Reports that describe the history of a single patient, or a group of patients, usually in the form of a story. Case Study An intensive investigation of a case involving a person or small group of persons, an issue or an event. Expert Opinion/ Manufacturer’s Recommendations Melnyk, B. & Fineout-Overholt,, E. (2011). Evidence-based practice in nursing and healthcare: A guide to best practice (2nd Ed.). Philadelphia: Lippincott Williams and Wilkins. Level of Evidence Type of Evidence Strongest I (A) Evidence from systematic review or meta-analysis of multiple controlled studies with results that consistently support a specific action, intervention or treatment II (B) Evidence from at least one well designed controlled study, randomized & non-randomized, with results that support a specific action, intervention or treatment III (C) Evidence from qualitative studies, descriptive or correlational studies, integrative reviews or randomized controlled trials with inconsistent results IV (D) Evidence from peer reviewed professional organizational standards, with clinical evidence to support recommendations; Includes non-experimental studies V (E) Weakest Evidence from theory based evidence from expert opinion or multiple case reports; Interpretation of non-research based information by experts VI (M) Manufacturers’ recommendations only Based on: AACN’s evidence-leveling system Armola, R.R., Bourgault, A.M., Halm, M.A., Board, R.M, Bucher, L, Harrington, L., Heafey, C… & Medina, J. (2009). Upgrading the American Association of Critical-Care Nurses’ evidence-leveling hierarchy. American Journal of Critical Care, 18, 405-40. Appendix B: Grading the Evidence Level of Evidence Quality Grading Guides Level I A High quality: consistent results, sufficient sample size, adequate control, and definitive conclusions; consistent recommendations on extensive literature review that includes thoughtful reference to scientific evidence. Level II
non_research_appraisal_tool_1-6-17.docx