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Evidence used in the ACORN Standards

Evidence grading for the 2023 SSQCPE

ACORN commissioned the Joanna Briggs Institute (JBI)1 to prepare evidence summaries of the best available evidence for each standard in the 2023 SSQCPE. During the commission, JBI worked with ACORN’s Standards Manager and ACORN expert members to develop an individual standard PICO (Patient/Population, Intervention, Comparison and Outcome) question that JBI could apply to their rapid searches for the best available evidence. In targeting the best available evidence, JBI focused on systematic reviews, evidence-based guidelines and then primary research that measured the effects or effectiveness of health care policy and practice. JBI searched the following bibliographic citation databases to locate relevant studies.

  • MEDLINE via Pubmed
  • JBI Database of Systematic Reviews and Implementations Reports
  • JBI EBP Databse via OVID
  • Cochrane Library
  • Guidelines International Network Library.

Each search was limited to the last five years for contemporary literature and limited to English language papers only. The reference lists of included studies were reviewed to identify additional studies of relevance. Following each search, JBI critically appraised data from identified reviews, studies, guidelines and other forms of evidence using the appropriate JBI critical appraisal tools. (JBI critical appraisal tools are available from JBI evaluated the quality of the evidence and extracted key characteristics to inform the evidence summary underpinning each standard.

Following critical appraisal relevant studies were extracted against the template for data extraction to identify key outcome data. In the absence of research, evidence, text and opinion was extracted to ensure answers to each topic were based on publicly accessible and vetted knowledge.

JBI provided ACORN with a series of topic-specific detailed evidence summaries. Each summary included recommendations for practice. JBI assigned a level of evidence Grade A or Grade B according to JBI levels of evidence to all evidence points included in the summary.1 These levels are included with the associated criteria in each standard. ACORN is unable to align the JBI evidence grades to Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence levels.2

Additional evidence for some but not all of the standards was identified by content experts and review of the reference lists of the primary citations. In each standard, criteria and guidance were informed by the evidence. Factors considered by the Standards Manager in the review of the collective evidence were the quality of the evidence, the quantity of similar evidence on a given topic and the consistency of evidence supporting a recommendation.


  1. Joanna Briggs Institute (JBI). Supporting document for the JBI levels of evidence and grades of recommendation [Internet]. Adelaide: JBI; 2014 [cited 2022 Nov 03]. Available from:
  2. National Health and Medical Research Council (NHMRC). Guidelines for guidelines: Assessing certainty of evidence [Internet]. Canberra: NHMRC; 2019 [updated 2019 Sep 6, cited 2022 Nov 03]. Available from: