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What is Evidence-Based Practice?

Evidence-based practice incorporates scientific evidence, client perspectives, and clinical expertise. Image from

Book: Dang, D., Dearholt, S., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and Guidelines (Fourth). Sigma Theta Tau International.


Protocols and Standards for Systematic Reviews

Cochrane Handbook for Systematic Reviews of Interventions
The Cochrane Handbook details how Cochrane reviews are conducted. This includes definitions for various risks of bias and standards for conducting meta-analyses.

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRIMSA) focuses on the reporting of systematic reviews but also includes protocol information.

Identifying Systematic Reviews

Levels of Evidence

The highest-quality clinical practice guidelines are based on the strongest evidence, meta-analyses and systematic reviews. Pyramid of evidence image from Baystate Health Libraries, CC BY-SA 4.0.

Oxford Centre for Evidence-Based Medicine: Levels of Evidence

Chart adapted from Grove, S. K., Burns, N., Gray, J. (2013). The practice of nursing research: Appraisal, synthesis, and generation of evidence. Elsevier/Saunders.

Level 1 (Highest Quality)

Systematic review of experimental studies (well-designed randomized control trials) and meta-analyses

Level 2

Meta-analysis of experimental (RCT) and quasi-experimental studies

Level 3

Integrative reviews of experimental (RCT) and quasi-experimental

Level 4

Single experimental study (RCT)

Level 5

Single quasi-experimental study

Level 6

Meta-analysis of correlational studies

Level 7

Integrative reviews of correlational and descriptive studies

Level 8

Mixed methods systematic review of quantitative, qualitative, and mixed methods studies

Level 9

Meta-synthesis of qualitative research

Level 10

Single correlational study

Level 11

Single qualitative or descriptive study

Level 12

Opinions of respected authorities based upon clinical evidence, reports of expert committees

Finding Systematic Reviews