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What is Evidence-Based Practice?

“Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values. When delivered in a context of caring and in a supportive organizational culture, the highest quality of care and best patient outcomes can be achieved.”

Melnyk, B., Fineout-Overholt, E., Stillwell, S., & Williamson, K. (2009). Evidence-based practice: step by step. Igniting a spirit of inquiry. American Journal of Nursing, 109(11), 49-52. doi:10.1097/01.NAJ.0000363354.53883.58

The EBM Triad

Source: Florida State University, College of Medicine


Twelve articles were published in the American Journal of Nursing (AJN) to give nurses the knowledge and skills they need to implement EBP consistently, one step at a time. The series was authored by faculty from the Arizona State University College of Nursing and Health Innovation's Center for the Advancement of Evidence-Based Practice.

The series received the Nursing Media Award for Print from Sigma Theta Tau International Awards for Nursing Excellence.

Multi-disciplinary tutorials

Learn the basics of evidence-based practice through these self-paced tutorials.

Evidence Pyramid

Medical scientists and practitioners rank evidence according to its quality. When these types of evidence are ranked as levels, one on top of the other, the resulting image takes the form of a pyramid, because the higher the quality of evidence, the rarer it is, and the lower the quality of evidence, the more ubiquitous it is. The highest quality evidence (level 1 evidence) is the systematic review:

Hierarchy of evidence pyramid: top to bottom, systematic reviews, randomised control trials, cohort studies, case control studies, case series and reports, editorials and expert opinion


EBP Glossaries

Types of study designs

Systematic Review 
A summary of the clinical literature. A systematic review is a critical assessment and evaluation of all research studies that address a particular clinical issue. The researchers use an organized method of locating, assembling, and evaluating a body of literature on a particular topic using a set of specific criteria. A systematic review typically includes a description of the findings of the collection of research studies. (AHRQ Glossary of Terms)

A work consisting of studies using a quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc. It is often an overview of clinical trials. It is usually called a meta-analysis by the author or sponsoring body and should be differentiated from reviews of literature. (PubMed)

Randomized Controlled Trial 
A controlled clinical trial that randomly (by chance) assigns participants to two or more groups. There are various methods to randomize study participants to their groups. (AHRQ Glossary of Terms)

Controlled Clinical Trial 
A type of clinical trial comparing the effectiveness of one medication or treatment with the effectiveness of another medication or treatment. In many controlled trials, the other treatment is a placebo (inactive substance) and is considered the "control." (AHRQ Glossary of Terms)

Cohort Study 
A clinical research study in which people who presently have a certain condition or receive a particular treatment are followed over time and compared with another group of people who are not affected by the condition. (AHRQ Glossary of Terms)

Case Control Study
The observational epidemiologic study of persons with the disease (or other outcome variable) of interest and a suitable control (comparison, reference) group of persons without the disease. The relationship of an attribute to the disease is examined by comparing the diseased and nondiseased with regard to how frequently the attribute is present or, if quantitative, the levels of the attribute, in each of the groups. (OCEBM Table of Evidence Glossary)

Case Series
A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. (OCEBM Table of Evidence Glossary)

Case Study
An investigation of a single subject or a single unit, which could be a small number of individuals who seem to be representative of a larger group or very different from it. (Dictionary of Nursing Theory and Research, Fourth Edition)

Work consisting of a statement of the opinions, beliefs, and policy of the editor or publisher of a journal, usually on current matters of medical or scientific significance to the medical community or society at large. The editorials published by editors of journals representing the official organ of a society or organization are generally substantive. (PubMed)

A belief or conclusion held with confidence but not substantiated by positive knowledge or proof. (The Free Dictionary)

Animal Research
A laboratory experiment using animals to study the development and progression of diseases. Animal studies also test how safe and effective new treatments are before they are tested in people.(NCI Dictionary of Cancer Terms)

In Vitro Research
In the laboratory (outside the body). The opposite of in vivo (in the body). (NCI Dictionary of Cancer Terms)

Video: Is it a research article?

Additional resources

Additional Resources

Other helpful sites for distinguishing between different types of research:

Study design

Clinical Concern Study Design of Choice
Therapy Randomized controlled trial; cohort; case control or case series
Diagnosis Prospective; blind comparison
Etiology or harm Randomized controlled trial; cohort; case control or case series
Prognosis Cohort, case control, case series
Prevention Randomized controlled trial; cohort; case control or case series
Clinical examination Prospective; blind comparison to a 'gold standard study'

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