Please review the complete instructions on attached document.

Johns Hopkins Nursing Evidence-Based Practice

Appendix C: Evidence Level and Quality Guide

©

The Johns Hopkins Hospital/Johns Hopkins University.  May not be used or reprinted without permission.                               Page 1   
 
         
 

Evidence Levels

Quality Guides

Level I
Experimental study, randomized controlled trial (RCT)
Systematic review of RCTs, with or without meta-analysis

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, 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

Level II
Quasi-experimental study
Systematic review of a combination of RCTs and quasi-
experimental, or quasi-experimental studies only, with or without
meta-analysis

Level III
Non-experimental study
Systematic review of a combination of RCTs, quasi-experimental
and non-experimental studies, or non-experimental studies only,
with or without meta-analysis
Qualitative study or systematic review with or without a meta-
synthesis

Johns Hopkins Nursing Evidence-Based Practice
Appendix C: Evidence Level and Quality Guide

© The Johns Hopkins Hospital/Johns Hopkins University.  May not be used or reprinted without permission.                               Page 2   
 
         
 

Evidence Levels

Quality Guides

Level IV
Opinion of respected authorities and/or nationally recognized
expert committees/consensus panels based on scientific evidence

Includes:
 Clinical practice guidelines
 Consensus panels

A High quality: Material officially sponsored by a professional, public, private
organization, or government agency; documentation of a systematic literature
search strategy; consistent results with sufficient numbers of well-designed studies;
criteria-based evaluation of overall scientific strength and quality of included studies
and definitive conclusions; national expertise is clearly evident; developed or
revised within the last 5 years

B Good quality: Material officially sponsored by a professional, public, private

organization, or government agency; reasonably thorough and appropriate
systematic literature search strategy; reasonably consistent results, sufficient
numbers of well-designed studies; evaluation of strengths and limitations of
included studies with fairly definitive conclusions; national expertise is clearly
evident; developed or revised within the last 5 years

C Low quality or major flaws: Material not sponsored by an official organization or

agency; undefined, poorly defined, or limited literature search strategy; no
evaluation of strengths and limitations of included studies, insufficient evidence with
inconsistent results, conclusions cannot be drawn; not revised within the last 5
years

Johns Hopkins Nursing Evidence-Based Practice
Appendix C: Evidence Level and Quality Guide

© The Johns Hopkins Hospital/Johns Hopkins University.  May not be used or reprinted without permission.                               Page 3   
 
         
 

Level V
Based on experiential and non-research evidence

Includes:
 Literature reviews
 Quality improvement, program or financial evaluation
 Case reports
 Opinion of nationally recognized experts(s) based on

experiential evidence

Organizational Experience:

A High quality: Clear aims and objectives; consistent results across multiple settings;
formal quality improvement, financial or program evaluation methods used;
definitive conclusions; consistent recommendations with thorough reference to
scientific evidence

B Good quality: Clear aims and objectives; consistent results in a single setting;

formal quality improvement or financial or program evaluation methods used;
reasonably consistent recommendations with some reference to scientific evidence

C Low quality or major flaws: Unclear or missing aims and objectives; inconsistent

results; poorly defined quality improvement, financial or program evaluation
methods; recommendations cannot be made

Literature Review, Expert Opinion, Case Report, Community
Standard, Clinician Experience, Consumer Preference:

A High quality: Expertise is clearly evident; draws definitive conclusions; provides
scientific rationale; thought leader(s) in the field

B Good quality: Expertise appears to be credible; draws fairly definitive conclusions;

provides logical argument for opinions

C Low quality or major flaws: Expertise is not discernable or is dubious; conclusions

cannot be drawn

6

0

(60

.00%)

Points

Range:

0 

(0.00%)

–

62

(62.00%)

The

present

ation inaccurately and v

aguely identifies and describes

the

chosen clinical

issue of interest

or is missing.

The presentation inaccurately and vaguely describes the developed PICO(T) question,

or is missing.
The presentation inaccurately and v

aguely identifies less than four research databases

used to conduct a search for the

peer

–

reviewed articles selected or is missing.

The presentation inaccurately and vaguely provides

APA

citations

for at least four peer

–

reviewed articles selected, includi

ng an inaccurate and vague explanation of the

strengths of using systematic reviews for clinical research, or is missing.

The presentation includes inaccurate and vague examples to support the research

presented or is missing.

The presentation provides a

vague and inaccurate synthesis of no outside resources

related to the articles selected and fails to integrate any resources to support the

presentation or is missing.

Feedback:

APA – citations –

see et al. rule and apply in citations with more than 2 aut

hors. See

common ref list examples in writing center and how to format journal articles per APA.

Be sure to utilize at least two filtered databases when conducting search for systematic

reviews. Databases such as Joanna Briggs and Cochrane. Articles select

ed and not

representative of Systematic Review, they are primary research articles. Therefore, no

points can be earned for said articles. See page 171 in textbook. A systematic review is

secondary research

—

uses research that was co

nducted

previously (pr

imary research).

Systematic Reviews are extremely detailed and look at throughout many databases to

collect all the primary research studies done on the topic. See page 171 in textbook. A

systematic review is secondary research

— uses research that was conducted

previously (primary research). Systematic Reviews are extremely detailed and look at

throughout many databases to collect all the primary research studies done on the

topic. Level of Evidence in Peer

–

Reviewed Articles

–

be sure to share for each of

the peer-

reviewed articles the level of evidence based on a particular source

–

explain

–

did

this represent the Hierarchy of Evidence (see textbook page 18 or other course

resources), or John Hopkins Level of Evidence shared? Remember, Level 1 are

consid

ered the highest level and representative of Systematic Reviews

—

in primary

studies, such as the articles you located, those are lower on the hierarchy of evidence

pyramid. List all reference together on the last Reference page

–

include all. In

present

ation include a thorough and detailed explanation of the strengths of using

systematic reviews for clinical research. From the articles you located, what strengths

did you note from the systematic review

—

did it shed some light into discovery of the

PICOT answer? What other strengths from systematic reviews did you learn about from various course resources?

3.5 (3.50%)

Points Range:3.5 (3.50%) – 3.5 (3.50%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time.
Purpose, introduction, and conclusion of the assignment is vague or off topic.

Feedback:

always have a clear purpose statement and conclusion

60

(60
.00%)

Points

Range:
0

(0.00%)

–

62

(62.00%)

The presentation inaccurately and vaguely identifies and describes the chosen clinical

issue of interest or is missing.

The presentation inaccurately and vaguely describes the developed PICO(T) question,
or is missing.

The presentation inaccurately and v
aguely identifies less than four research databases
used to conduct a search for the peer
–
reviewed articles selected or is missing.

The presentation inaccurately and vaguely provides APA citations for at least four peer
–
reviewed articles selected, includi
ng an inaccurate and vague explanation of the
strengths of using systematic reviews for clinical research, or is missing.

The presentation includes inaccurate and vague examples to support the research
presented or is missing.

The presentation provides a

vague and inaccurate synthesis of no outside resources
related to the articles selected and fails to integrate any resources to support the
presentation or is missing.

Feedback:

APA
–

citations
–

see et al. rule and apply in citations with more than 2 aut
hors. See
common ref list examples in writing center and how to format journal articles per APA.
Be sure to utilize at least two filtered databases when conducting search for systematic
reviews. Databases such as Joanna Briggs and Cochrane. Articles select
ed and not
representative of Systematic Review, they are primary research articles. Therefore, no
points can be earned for said articles. See page 171 in textbook. A systematic review is
secondary research
—

uses research that was conducted previously (pr
imary research).
Systematic Reviews are extremely detailed and look at throughout many databases to
collect all the primary research studies done on the topic. See page 171 in textbook. A
systematic review is secondary research
—

uses research that was co
nducted
previously (primary research). Systematic Reviews are extremely detailed and look at
throughout many databases to collect all the primary research studies done on the
topic. Level of Evidence in Peer
–
Reviewed Articles
–

be sure to share for each of

the
peer
–
reviewed articles the level of evidence based on a particular source
–

explain
–

did
this represent the Hierarchy of Evidence (see textbook page 18 or other course
resources), or John Hopkins Level of Evidence shared? Remember, Level 1 are
consid
ered the highest level and representative of Systematic Reviews
—

in primary
studies, such as the articles you located, those are lower on the hierarchy of evidence
pyramid. List all reference together on the last Reference page
–

include all. In
present
ation include a thorough and detailed explanation of the strengths of using
systematic reviews for clinical research. From the articles you located, what strengths
did you note from the systematic review
—

did it shed some light into discovery of the

60 (60.00%)

Points Range:0 (0.00%) – 62 (62.00%)

The presentation inaccurately and vaguely identifies and describes the chosen clinical

issue of interest

or is missing.

The presentation inaccurately and vaguely describes the developed PICO(T) question,
or is missing.

The presentation inaccurately and vaguely identifies less than four research databases

used to conduct a search for the peer-reviewed articles selected or is missing.

The presentation inaccurately and vaguely provides APA citations for at least four peer-

reviewed articles selected, including an inaccurate and vague explanation of the

strengths of using systematic reviews for clinical research, or is missing.

The presentation includes inaccurate and vague examples to support the research

presented or is missing.

The presentation provides a vague and inaccurate synthesis of no outside resources

related to the articles selected and fails to integrate any resources to support the

presentation or is missing.

Feedback:

APA – citations – see et al. rule and apply in citations with more than 2 authors. See

common ref list examples in writing center and how to format journal articles per APA.
Be sure to utilize at least two filtered databases when conducting search for systematic

reviews. Databases such as Joanna Briggs and Cochrane. Articles selected and not

representative of Systematic Review, they are primary research articles. Therefore, no
points can be earned for said articles. See page 171 in textbook. A systematic review is

secondary research — uses research that was conducted previously (primary research).

Systematic Reviews are extremely detailed and look at throughout many databases to
collect all the primary research studies done on the topic. See page 171 in textbook. A

systematic review is secondary research — uses research that was conducted

previously (primary research). Systematic Reviews are extremely detailed and look at
throughout many databases to collect all the primary research studies done on the

topic. Level of Evidence in Peer-Reviewed Articles – be sure to share for each of the

peer-reviewed articles the level of evidence based on a particular source – explain – did

this represent the Hierarchy of Evidence (see textbook page 18 or other course
resources), or John Hopkins Level of Evidence shared? Remember, Level 1 are

considered the highest level and representative of Systematic Reviews — in primary

studies, such as the articles you located, those are lower on the hierarchy of evidence

pyramid. List all reference together on the last Reference page – include all. In

presentation include a thorough and detailed explanation of the strengths of using

systematic reviews for clinical research. From the articles you located, what strengths

did you note from the systematic review — did it shed some light into discovery of the