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Medical scientists and practitioners rank evidence according to its quality. When these types of evidence are ranked as levels, one on top of the other, the resulting image takes the form of a pyramid. This is because the higher the quality of evidence, the rarer it is, and the lower the quality of evidence, the more ubiquitous it is. The highest quality evidence (level 1 evidence) is the systematic review:
Levels of Evidence (Video, Duration: 8min.) University of Louisville, 2018.
The first stage of any evidence-based practice process is formulating an answerable question. This forms the foundation for quality searching. A well-formulated question will facilitate the search for evidence and will assist you in determining whether the evidence is relevant to your question.
There are a number of frameworks available and the one you use will depend on your discipline area and the focus of your question. Examples include PICO, ECLIPSE, SPIDER and SPICE.
See the “Framing your research question” guide for more information on frameworks.
CQUniversity Library pays for subscription licenses to scholarly publications. Your hospital library in the clinical setting may also provide full-text access to some of these resources.
You can locate CQUniversity’s Evidence-Based Practice databases under the Type of Resource, Evidence-Based Practice section of the library Databases page.
Critical appraisal uses intrinsic (research design, not extrinsic (author, journal, institution)) factors. You'll need to consider the following when appraising an article:
These videos will provide an introduction to the concept of critical appraisal.
Introduction to Critical Appraisal (Video, Duration 9min.)
Developed by Cochrane Common Mental Disorders in collaboration with York University, Northumberland, Tyne and Wear NHS Foundation Trust (NTW), UK and Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV), UK.
Systematic reviews and meta-analysis (Video, Duration: 29min.)
Developed by Cochrane Common Mental Disorders in collaboration with York University, Northumberland, Tyne and Wear NHS Foundation Trust (NTW), UK and Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV), UK.
You can use this worksheet to help you with your PICO and search strategy for your assignment question.
See Framing your question for more information about question frameworks like PICO and it's variants.
There are a number of checklists / tools available on the Internet to assist you in undertaking critical appraisal of evidence. Some examples are listed below.
There are several valuable resources available on the Internet. Many are from government departments, educational institutions, or not-for-profit organisations. Below are a couple of examples of the resources available.
Note: Before using any websites, you need to evaluate the content and reliability of each site carefully.
You can improve your chances of finding relevant information by limiting your search results. To do this you can use the advanced search option and limit to education, government, or organisation domains. The following search strategies could be used in Google:
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