Hierarchy Of Evidence Essay

The hierarchy of evidence utilized to evaluate the strength of evidence for each article was the Oxford Centre for Evidence-based Medicine – Levels of Evidence table obtained from the Center for Evidenced Based Medicine (2009). The search engines and databases searched in the literature review were chosen to optimize the literature search for high quality evidence. CINAHL (Current Index to Nursing & Allied Health Literature) is a bibliographic search database, which contains references to articles from over 2,900 journals as well as a great number of government documents, dissertations, and standards of practice articles (Chapman, 2009). MEDLINE is the National Library of Medicine journal citation database. As one of the world’s largest search …show more content…
In regards to articles discussing opioid screening in particular, a majority of the identified articles were relevant to chronic pain while very few related to chronic and acute pain or acute pain alone. The decision to include or exclude particular articles was based on relevancy to the PICO question, the quality of the evidence, and the nature of the article subject matter. Articles selected for inclusion in the evidence were based on the quality of the evidence and relevance to the PICO question. Discrepancies related to which articles to include in the appraisal of evidence was resolved via verbal discussion between the two reviewers. If resolve could not be accomplished, the project chairs would be consulted on the appropriateness of an article for inclusion. The final selection of articles meeting the inclusion criteria as supportive evidence relevant to the PICO question is displayed in the Literature Matrix Grid [Table 2]. This includes 25 articles ranging from systematic reviews, level I evidence, to cross sectional surveys, level V evidence on the hierarchy of evidence pyramid (Center for Evidenced Based Medicine,