Evidence-Based Practice

After performing your searches, you must appraise the evidence for its validity, impact, and applicability. 

• Are the results of the study valid?
  Are the research methods used in this study rigorous enough to have findings that are as close to the truth as possible?  Did the researchers introduce any bias in designing their study?  Were the methods of collecting evidence standardized to avoid manipulation?  Were the equipment and instruments used in the study considered reliable?
• What are the results and are they important?
  Did the intervention work?  What is the impact of this study on the field?  Can the results be replicated or confirmed in similar settings?
• Will the results help me care for my patients?
  Are the subjects of the study similar to your patient?  Do the benefits outweigh the risks?  Is it cost-effective?  Are the patient's values and preferences being considered?

The flow diagram depicts the process of evaluation and appraisal of evidence.  It maps out the number of records identified and included.  Some PRISMA diagrams also include excluded papers and the reasons for exclusion.  This is the simplest form of the diagram:

Things to Remember with PRISMA:

• The letter "n" equals the number of results or articles
• "Other Sources" are any articles included in your review that weren't found on a results list from a database.  These can include articles found in the references of other articles and anything found from Google Scholar
• Screening a record can be as simple as skimming a title