Skip to Main Content

Evidence Based Practice

Understanding the Evidence

The highest or strongest levels of evidence appear near the top of the Evidence Pyramid, and can be harder to find (if such evidence exists at all). 

Not sure where on the evidence pyramid to place an article you have found? Not sure what type of study design is being used? This article may help you decide...

 Ingham-Broomfield, R. (2016). A nurses' guide to the hierarchy of research designs and evidence. Australian Journal of Advanced Nursing, 33(3), 38-43. https://www.ajan.com.au /archive/Vol33/Issue3/5Broomfield.pdf

Secondary Sources

Secondary sources are summaries and analyses of the evidence derived from and based on primary sources. They provide an appraisal of the quality of studies and often make recommendations for practice.

What kinds of studies are considered as Secondary sources?
  • Clinical Practice Guidelines (CPG)
  • Meta-Analyses (MA)
  • Systematic Reviews (SR)
  • Critically Appraised Topics (CAT)
  • Critically Appraised Articles (CAA)

Clinical Practice Guidelines (CPGs) are practice recommendations based on the best available evidence written by healthcare organizations. Guidelines are meant as recommendations for evidence-based patient care.

Search the library databases or try the following suggestions and links...


Specific

For specific guidelines use a search engine with the following keywords:

"clinical practice guidelines" AND "your topic"

e.g. "clinical practice guidelines" AND "chronic pain"


Some General Examples

Systematic Reviews (SRs) focus on peer-reviewed publications about a specific problem. Rigorous, standardized methods for selecting and assessing articles are used to limit bias in the assembly, critical appraisal, and synthesis of all relevant studies on a specific topic.

A systematic review may or may not include a Meta-Analysis (MA) which is a quantitative summary of the results.

Search the library databases or try the following suggestions and links...

A Critically Appraised Topic (CAT) is a short summary of the best available evidence, created to answer a specific clinical question. it is liked a concise and less rigorous version of a systematic review.

Search the library databases (just add the phrase "critically appraised topic" to your search, or try the links below...

Critically Appraisal Articles (CAA) are structured abstracts and expert commentaries for a particular topic. In certain databases, they are also also known as Review Articles. 

Protocol
A defined framework that outlines the care to be provided to patients in a specific area of practice. It focuses on the rationale, timing, location, and the individuals responsible for delivering the care, rather than detailing the steps of a procedure.
SAMPLE ARTICLE : [ Protocol ]

Standard
A consensus-based statement that clearly defines the desired outcome, typically used in audits as a measure of success.
SAMPLE ARTICLE : [ Standards of Medical Care in Diabetes ]

Guideline 
Statements derived systematically to assist practitioners in making decisions about care in specific clinical situations. These should be based on research or evidence.
SAMPLE ARTICLE : [ Jaundice in newborn babies under 28 days ]

Primary Sources

Primary sources in the field of medical and health sciences are typically journal articles detailing original research. They are important because they are often the original sources of new knowledge. An example of a primary sources is a quantitative or qualitative research study that describes an intervention and its outcome on a specific population.

What kinds of studies are considered as Primary Sources?
  • Clinical Trials
  • Randomized Control Trials
  • Multicentre Studies
  • Epidemiology Studies
  • Prospective Studies
  • Retrospective Studies
  • Cohort Studies
  • Case Control Studies
  • Cross-sectional studies
  • Case reports / Case series

Search the library databases or try the following links...

Professional organizations are a great place to start looking for current events, issues facing practitioners, and conflicts within the health law arena.

Policy
A formal written statement detailing the particular action to be taken in a particular situation that is contractually binding.
SAMPLE ARTICLE : [ Policy ]

Regulation
The core purpose of the legislation was to give the public the right to make decisions about their life and healthcare. It is crucial for you to understand the relevant regulations in order to make binding, legally enforceable decisions for both yourself and your patients.
SAMPLE ARTICLE : [ PHMC Act ]

Test your knowledge of types of information