MM 2 forms
Johns Hopkins Evidence-Based Practice Model for Nursing and Healthcare Professionals
Hierarchy of Evidence Guide
Appendix D
© 2022 Johns Hopkins Health System/Johns Hopkins School of Nursing P a g e | 1
Note: Refer to the appropriate Evidence Appraisal Tool (Research [Appendix E] or Nonresearch [Appendix F]) to determine quality ratings.
Evidence Level Types of Evidence
R
es
ea
rc
h
E
vi
de
nc
e
(A
pp
en
di
x
E
)
Level I
• Experimental study, randomized controlled trial (RCT)
• Explanatory mixed methods design that includes only a Level I quaNtitative study
• Systematic review of RCTs, with or without meta-analysis
Level II
• Quasi-experimental study
• Explanatory mixed methods design that includes only a Level II quaNtitative study
• Systematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental
studies only, with or without meta-analysis
Level III
• Nonexperimental study
• Systematic review of a combination of RCTs, quasi-experimental and nonexperimental studies, or
nonexperimental studies only, with or without meta-analysis.
• Exploratory, convergent, or multiphasic mixed methods studies
• Explanatory mixed methods design that includes only a Level III quaNtitative study
• QuaLitative study
• Systematic review of quaLitative studies with or without meta-synthesis
N
on
re
se
ar
ch
E
vi
de
nc
e
(A
pp
en
di
x
F)
Level IV
Opinion of respected authorities and/or nationally recognized expert committees or consensus panels based
on scientific evidence. Includes:
• Clinical practice guidelines
• Consensus panels/position statements
Level V
Based on experiential and non-research evidence. Includes:
• Scoping reviews
• Integrative reviews
• Literature reviews
• Quality improvement, program or financial evaluation
• Case reports
• Opinion of nationally recognized expert(s) based on experiential evidence
