on clinical, behavioral, organizational, and financial topics to produce evidence
reports and technology assessments (AHRQ, 2002, 2016). EPCs also conduct
research on methodology and systematic reviews, and evidence-based reports
are added to the AHRQ website on a regular basis (AHRQ, n.d.).
The Cochrane Collaboration, founded in 1993, is an international not-for-profit
organization that is dedicated to disseminating information about the effects
of health care worldwide. The Cochrane Collaboration has several resources
at the disposal of evidence-based practitioners, one of them being the Co-
chrane Database of Systematic Reviews, published on a continuous basis
from the Cochrane Library (http://www.cochranelibrary.com/). The Cochrane
Collaboration is best known for its comprehensive evidence-based summa-
ries written in an easy-to-read style. Existing Cochrane Reviews are updated
regularly, keeping pace with the fast-paced healthcare environment.
The Joanna Briggs Institute (2014) is an international not-for-profit research
organization that is part of the School of Translational Science at the University
of Adelaide, South Australia. Its central mission is to evaluate health outcomes
for the client and community from an economic and clinical perspective. The
institute also focuses on the evaluation of research. It identifies topics for sys-
tematic review, plans the review, and uses expert panels and reviewers to publish
systematic reviews. With more than 70 collaborating entities, the Joanna Briggs
Institute has an international presence, providing the best clinical evidence at
the point of care. Factors such as feasibility, meaningfulness, effectiveness, and
appropriateness are some of the aspects that are critiqued. The Joanna Briggs
Institute (2011) uses these factors to grade recommendations used in CPGs and
gives them numbered levels. The institute has an array of resources to appraise
the research evidence, assist in the process of conducting a systematic review,
and facilitate thematic analysis of primary data.
Clearly, there are many evidence rating and grading schemes. There is con-
troversy about which scheme provides the best evaluation. Yet deciding on
one universal rating scheme may not be feasible. Grades of Recommendations,
Read the following description and determine how you would rank this study using the rating
system in Figure 15-1.
The purpose of this experimental study was to test the efficacy of two interventions for
mothers and their adolescents in delaying initiation of sexual intercourse for youth who
are not sexually active and encouraging the use of condoms among sexually active youth.
Adolescents (N = 582) and their mothers were randomly assigned to one of two groups
(Dilorio et al., 2006).CRITICAL THINKING EXERCISE 15-1
KEY TERM
systematic
reviews: Rigorous
and systematic
syntheses of
research findings
about clinical
problems15.2 Appraising the Evidence 411