The "6S" pyramid hierarchy of preappraised evidence developed by DiCenso, Bayley, & Haynes (2009) provides a means to help nurse consumers of research find preappraised evidence for clinical questions
Using this model, which level of evidence would be highest?
a. Summaries such as clinical practice guidelines
b. Synopsis of Synthesis such as summaries found in the journal Evidence-Based Nursing
c. Syntheses or systematic reviews such as a Cochrane review
d. Studies such as synopses of a single study
ANS: A
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A The highest level of those presented in the question is Summaries, which include clinical practice guidelines and electronic evidence-based textbooks. These summaries about specific conditions are updated regularly. An even higher level of the 6S pyramid is Computerized Decision Support Systems (CDSS), which integrate evidence-based clinical information into an electronic medical record. At present, these systems are not a reality in most institutions and, therefore, they were not included as an option in this question.
B Next highest is Synopsis of Synthesis, which provides a preappraised summary of a systematic review that can be found in journals, such as Evidence-Based Nursing.
C Third highest is Syntheses or systematic reviews such as a Cochrane review.
D Lowest in the hierarchy is Studies, which often refer to synopses of single studies evaluated by a single expert.
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