7 Evidence Appraisal: Nonresearch 157
publications on the topic; see whether others have cited the author’s work; or see
whether the author is a recognized speaker. For example, Netherwood, Skittrall,
and Alexis (2014) provide an expert opinion on regulation of nursing assistants.
This article could be rated high-quality because the authors are faculty members
of a school of nursing and have additional publications on this topic. Their re-
port is based on the literature with data supporting their opinion.
Case Report (Level V Evidence)
Case reports are commonly used in healthcare as a means of disseminating infor-
mation on unusual clinical situations or scenarios, are used as educational tools,
and are easily accessible. These reports present a summary or anecdotal descrip-
tion that leads to new insights or alternative explanations or challenges current
understanding (Polit & Beck, 2017). Though case reports can provide the EBP
team with insights into a specific clinical situation, they have limited generaliz-
ability and, therefore, are Level V evidence. Case reports should not be confused
with case studies. Case studies involve a collection of qualitative or quantitative
information, may use statistical methods to analyze the data, employ in-depth
investigation over time, or study relationships and trends. In these instances, they
are considered quantitative, qualitative, or mixed methods research (Sandelows-
ki, 2011).
“A case report is a powerful tool to disseminate information
on unusual clinical syndromes, disease associations, unusual
side effects to therapy, or response to treatment. Case re-
ports have been used for years as a means to teach health
sciences students, and are one of the best ways for authors
to get started in scholarly writing, and can be a valuable
learning experience for both author and reader. Case reports
continue to be a very popular section within the Journal.
They are well read, and by nature they are easily accessible.”
(Gopikrishna, 2010)
