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JohnsHopkins Nursing Evidence-Based Practice

Appendix E: Research Evidence Appraisal Tool

Article Title:

Number:

Author(s):

Publication Date:

Journal:

Setting:

Sample
(Composition & size):

Does this evidence address my EBP question?

Yes

No
Do not proceed with appraisal of this evidence

Level of Evidence (Study Design)

A. Is this a report of a single research study? If No, go to B.

1. Was there manipulation of an independent variable?
2. Was there a control group?
3. Were study participants randomly assigned to the intervention and control

groups?

If Yes to all three, this is a Randomized Controlled Trial (RCT) or Experimental
Study

If Yes to #1 and #2 and No to #3, OR Yes to #1 and No to #2 and #3, this is Quasi

Experimental (some degree of investigator control, some manipulation of
an independent variable, lacks random assignment to groups, may have a
control group)

If No to #1, #2, and #3, this is Non-Experimental (no manipulation of independent

variable, can be descriptive, comparative, or correlational, often uses secondary
data) or Qualitative (exploratory in nature such as interviews or focus groups, a
starting point for studies for which little research currently exists, has small
sample sizes, may use results to design empirical studies)

NEXT, COMPLETE THE BOTTOM SECTION ON THE FOLLOWING PAGE, “STUDY
FINDINGS THAT HELP YOU ANSWER THE EBP QUESTION”

 LEVEL I

 LEVEL II

 LEVEL III

Yes

Yes
Yes

Yes

No

No
No

No

Evidence Level and Quality:_______________________

darlene.mccombs
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Johns Hopkins Nursing Evidence-Based Practice
Appendix E: Research Evidence Appraisal Tool

B. Is this a summary of multiple research studies? If No, go to Non-Research

Evidence Appraisal Form.

1. Does it employ a comprehensive search strategy and rigorous appraisal method
(Systematic Review)? If No, use Non-Research Evidence Appraisal Tool; if
Yes:

a. Does it combine and analyze results from the studies to generate a new
statistic (effect size)? (Systematic review with meta-analysis)

b. Does it analyze and synthesize concepts from qualitative studies?
(Systematic review with meta-synthesis)

If Yes to either a or b, go to #2B below.

2. For Systematic Reviews and Systematic Reviews with meta-analysis or meta-
synthesis:

a. Are all studies included RCTs?

b. Are the studies a combination of RCTs and quasi-experimental or
quasi-experimental only?

c. Are the studies a combination of RCTs, quasi-experimental and
non-experimental or non-experimental only?

d. Are any or all of the included studies qualitative?

COMPLETE THE NEXT SECTION, “STUDY FINDINGS THAT HELP YOU ANSWER
THE EBP QUESTION”

 LEVEL I

 LEVEL II

 LEVEL IIl

Yes

No

STUDY FINDINGS THAT HELP YOU ANSWER THE EBP QUESTION:

NOW COMPLETE THE FOLLOWING PAGE, “QUALITY APPRAISAL OF RESEARCH STUDIES”, AND ASSIGN A
QUALITY SCORE TO YOUR ARTICLE

Johns Hopkins Nursing Evidence-Based Practice
Appendix E: Research Evidence Appraisal Tool

Quality Appraisal of Research Studies

 Does the researcher identify what is known and not known about the problem and how the
study will address any gaps in knowledge?

 Was the purpose of the study clearly presented?
 Was the literature review current (most sources within last 5 years or classic)?
 Was sample size sufficient based on study design and rationale?
 If there is a control group:

o Were the characteristics and/or demographics similar in both the control and
intervention groups?

o If multiple settings were used, were the settings similar?
o Were all groups equally treated except for the intervention group(s)?

 Are data collection methods described clearly?
 Were the instruments reliable (Cronbach’s α [alpha] > 0.70)?
 Was instrument validity discussed?
 If surveys/questionnaires were used, was the response rate > 25%?
 Were the results presented clearly?
 If tables were presented, was the narrative consistent with the table content?
 Were study limitations identified and addressed?
 Were conclusions based on results?

Yes
Yes
Yes
Yes

Yes
Yes

Yes

No
No
No
No

No
No

No

NA

NA
NA

NA

Quality Appraisal of Systematic Review with or without Meta-Analysis or Meta-Synthesis

 Was the purpose of the systematic review clearly stated?
 Were reports comprehensive, with reproducible search strategy?

o Key search terms stated
o Multiple databases searched and identified
o Inclusion and exclusion criteria stated

 Was there a flow diagram showing the number of studies eliminated at each level of
review?

 Were details of included studies presented (design, sample, methods, results, outcomes,
strengths and limitations)?

 Were methods for appraising the strength of evidence (level and quality) described?
 Were conclusions based on results?

o Results were interpreted
o Conclusions flowed logically from the interpretation and systematic review question

 Did the systematic review include both a section addressing limitations and how they were
addressed?

Yes
Yes

Yes
Yes
Yes

Yes

Yes
Yes
Yes

Yes

No
No

No
No
No

No

No
No
No

No

QUALITY RATING BASED ON QUALITY APPRAISAL

A High quality: consistent, generalizable results; sufficient sample size for the study design; adequate control; definitive
conclusions; consistent recommendations based on comprehensive literature review that includes thorough reference
to scientific evidence

B Good quality: reasonably consistent results; sufficient sample size for the study design; some control, and fairly
definitive conclusions; reasonably consistent recommendations based on fairly comprehensive literature review that
includes some reference to scientific evidence

C Low quality or major flaws: little evidence with inconsistent results; insufficient sample size for the study design;
conclusions cannot be drawn

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