Two different methods used in the evaluation of evidence include the AORN Research Evidence Appraisal Tool and the Rapid Critical Appraisal. While both approaches help the reader determine quality and relevance to practice changes, the AORN Research Evidence Appraisal is a more in-depth tool. Using a Rapid Critical Appraisal allows the reader to determine the level of evidence, how well it was conducted, and how useful it is to practice. The hierarchy of scientific evidence goes from strongest to weakest:

Meta-analysis and systematic reviews

Randomized control trials

Control trial without randomization 

Case-control or study cohort

Systematic review of qualitative or descriptive studies

Qualitative or descriptive study

Expert opinion or consensus

Many times the level of evidence can be found in the abstract, making it easy to find the information and decipher the level of evidence quickly. When looking at how well the study was conducted, three questions may be answered:

Why was the study done?

What is the sample size?

Are the instruments of the major variables valid and reliable? 

The reader then must decide if the study and results are relevant to the practice change (Fineout-Overhault, Melnyk, Stillwell, & Williamson, 2010).

The AORN Research Evidence Appraisal Tool looks at the quality of evidence in the study and summary based on yes or no questions and rates the quality of evidence as High, Good, or Low quality/major flaws. While this approach is a more comprehensive tool, it takes a significant amount of time based on amount of articles being evaluated (Spruce, Van Wicklin, Hicks, Conner, & Dunn, 2014).  

Attached is a copy of the AORN REsearch and Evidence Appraisal Tool

Fineout-Overhault, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Evidence-based practice step by step: Critical

appraisal of the evidence: Part I . American Journal of Nursing, 47-52.


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