|
Author; Year |
The author(s), as formatted for a citation, followed by the year of publication in parentheses. |
|---|---|
| Objectives | The information the study aims to discover or confirm - the purpose of the study.. |
| Level |
The level of evidence (1-7) - as measured by the pyramid above. |
| Design |
The type of study, as seen on the pyramid above (e.g., Single Randomized Controlled Trial) |
|
Participants/Population |
The subjects of the study - number, age, gender, location, other identifying characteristics. The 'P' in PICO. |
| Intervention |
The treatment, procedure, or other intervention - what did the study do? The 'I' in PICO. |
|
Outcome Measures |
How does the study assess what the outcome is? |
| Outcome | The results of the study. The 'O' in PICO. |
| Limitations | Any shortcomings of the design of the study, the number of participants, the method of measuring the outcome, etc. (optional). |
| Implications | The meaning of the outcome: what do the results of the study help us to know? |
| Author; Year | Mehta, S. et al. (2012) |
|---|---|
| Objectives | To compare protocolized sedation with protocolized sedation plus daily sedation interruption in critically ill patients. |
| Level | 2 |
| Design | Randomized Controlled Trial |
| Participants/Population | 430 critically ill, mechanically ventilated adults in 16 tertiary care medical and surgical ICUs in Canada and the United States between January 2008 and July 2011 |
| Intervention |
Continuous opioid and/or benzodiazepine infusions and random allocation to protocolized sedation (n = 209) (control) or to protocolized sedation plus daily sedation interruption (n = 214). Using validated scales, nurses titrated infusions to achieve light sedation. For patients receiving daily interruption, nurses resumed infusions, if indicated, at half of previous doses. Patients were assessed for delirium and for readiness for unassisted breathing. |
| Outcome Measures | Time to successful extubation. Secondary outcomes included duration of stay, doses of sedatives and opioids, unintentional device removal, delirium, and nurse and respiratory therapist clinical workload (on a 10-point visual analog scale [VAS]). |
| Outcome | Median time to successful extubation was 7 days in both the interruption and control groups. Duration of ICU stay and hospital stay did not differ between the groups |
| Limitations | None noted. |
| Implications | The addition of daily sedation interruption did not reduce the duration of mechanical ventilation or ICU stay. |
Example Article: http://jamanetwork.com/journals/jama/fullarticle/1380160
Information and expert opinions - This base or foundational level is important in providing background information. However, this type of evidence is often biased by beliefs or political leanings.
Case-control studies or case series - In the early stages of research, this type of study looks at individuals retrospectively and compares them with similar groups. The weakness of this type of study is the small number of study participants, lack of randomization, or other confounding variables.
Cohort studies - Follow large groups over extended time periods to see how exposures affect outcomes. This type of study is often used to look at lifestyle risk factors not suitable for experiments. May include a control comparison but is difficult to randomize or control for variables.
Randomized Control Trial - The first level in the pyramid to use the experimental process. Two or more groups are investigated, one receiving the intervention and the other receiving either placebo, no intervention, or standard intervention.
Critically Appraised topics - Not a study design but rather short summaries of the best available evidence. More like an abbreviated systematic review.
Systematic Reviews and meta-analysis - The highest level on the evidence pyramid, this technique views all evidence, comparing results of studies side by side. This level is the highest quality of evidence. Meta-analysis can also be employed, which is the review and statistical summary of multiple studies.
Material summarized and derived from Minkow, Danny. 2014. The Evidence-Based Medicine Pyramid. Retrieved May 3, 2023, from https://s4be.cochrane.org/blog/2014/04/29/the-evidence-based-medicine-pyramid/
For more information about systematic reviews and evidence based practice, please refer to the following
Nursing research in Canada: methods, critical appraisal, and utilization,
Call No. Kiosk ; RT 81.5 .N8734 2022