After we have searched for the evidence, we need to decide if it is both valid and important before deciding if we can apply the evidence to our individual patients. The order in which we consider validity and importance depends on individual preference.
证据评价的步骤
首先你需要证据评价工具（评价工具可在本页下载），利用这些工具指导你完成证据的评价。
Note：This tool was created for your own personal use and testing purposes. Medical decisions should NOT be based solely on the results of this program. Although this program has been tested thoroughly, we are not responsible for any damages or loss of information. Please use at your own risk.
证据评价工具下载:
定性研究证据评价
1. 研究结果真是吗？Are the Results Valid (i.e., Are the Study Methods Strong/Rigorous?)
To figure out if the research results are valid, you need to examine the research methodology! Examining the research methodology means basically questioning every choice the researcher made in conducting the study (that they published).
You are looking for internal consistency between the quantitative or qualitative research design and the researcher’s choices. For example, for RCTs you’d want to find answers to: what specific type of trial design was used? how were the subjects chosen? what was the sample size? were the subjects randomized? were the subjects similar at the start of the study? was the attrition rate acceptable? was an intention-to-treat analysis performed? were the research instruments valid and reliable? etc.
This question is at the heart of critical appraisal because if the study methods are not valid, then you CANNOT BELIEVE THE RESULTS!
If the methods are suspect, you CANNOT BELIEVE the results and, therefore, should not waste your time reading the rest of the paper. Go find another study!
2.研究结果有意义吗？Are the Research Results/Findings Important?
If you’ve decided that the research methods are valid, then you can continue to read the study. At this point you want to look at the actual results or findings. So that means looking at the quantitative (numbers/stats) or qualitative findings (e.g., themes or theory).
For quantitative results, what is the relative risk, absolute risk, risk reduction, odds ratio, likelihood ratio, hazard ratio — whatever is appropriate for the type of study conducted. You want to evaluate the magnitude of the result (how big) and the significance of the result (statistical and clinical significance).
For qualitative findings, you want to reflect on the themes that the researcher identified from the participant data. Do the themes make sense with what the researcher reported about the participants? Do the themes make sense with the data? In other words, are the qualitative findings reliable and valid?
If the study was necessary, the methods strong, and the results statistically and clinically significant, then you can make a decision about how to translate the findings into your professional or advanced nursing practice.
3. 研究结果适用于我的患者吗？Can I Apply the Results to My Patient or Patient’s Situation?
This is the ultimate question, isn’t it? How do we translate research and evidence into practice so that it will benefit our patient?
You shouldn’t just use the research results or study findings on any patient. You first want to decide if your patient is similar to the sample used in the study. Look at the age range of the sample population, disease state, comorbidities, health status, etc. If your patient is NOT similar to the study sample, you can’t be confident that the treatment will perform in the manner described in the study article.
If your patient is a good match for the study sample, then you have to decide if the treatment will be acceptable or feasible in your particular practice setting. Not all settings will have the resources, or inclination, to treat the patients with evidence from the newest study.
Before talking with the healthcare team and the patient, the last consideration is whether the benefits of the new treatment will outweigh the potential risks or harms to the patient.
主要临床问题证据评价案例
Which type of evidence would you like to appraise?
