I need help doing a critical appraisal done for a paper. there are 5 articles. I have an example and the articles. It is supposed to support my PICOT question which is: In type 2 diabetic patients(P), how does the ketogenic diet(I) compare to the low-calorie diet (C) in the control of their HbA1c (O) in a one-year (T)time frame.

This is the example of what it is supposed to look like: It really only needs to be 3 paragraphs. And article 1&2 are both level one research.

Step 3: Critical Appraisal of the Evidence

            Performed Rapid critical appraisal checklists were used to evaluate the validity, reliability, and applicability to practice (Melnyk & Fineout-Overholt, 2011) for each of the studies found from the search. The systematic review by Watanabe and colleagues (2007) supported CBT and Interpersonal Psychotherapy (IPT) as effective treatments for adolescents with depression. In the search of PsycINFO and other databases, several meta-analyses of randomized controlled trials (RCTs), including one conducted by McCarty and Weisz (2007), supported CBT as an effective treatment for depressed adolescents. One of the RCTs, The Treatment of Adolescent Depression Study (TADS) by March, Hilgenberg, Silva, and TADS Team (2007) was a landmark 13 site RCT that compared (1) CBT, (2) placebo, (3) antidepressant medication (fluoxetine), and (4) a combination of fluoxetine and CBT. The study determined the superior effectiveness of the combination of CBT and fluoxetine in the acute and continuation treatment of adolescent major depression.

            The level I evidence, the strongest level of evidence to guide practice, found a systematic review and a meta-analysis of RCTs that tested the efficacy of CBT for adolescent depression. Level II evidence was also found in the TADS RCT, which is the strongest study design for con- trolling extraneous or confounding variables (Melnyk & Fineout-Overholt, 2011), and supported that CBT is a very efficacious treatment for adolescent depression. In the studies included in the meta-analysis, individual CBT sessions were 60 minutes long. Group CBT programs for adolescents were also included in the meta-analysis.

            Cited CBT treatment manuals for depressed adolescents in the studies were reviewed for their applicability to brief sessions. In these treatment manuals, the authors recommended individual CBT sessions of 60 minutes duration. For this project, a CBT-based intervention entitled COPE (Creating Opportunities for Personal Empowerment) (Melnyk, 2003) was selected because it included all of the components identified in the literature that comprise effective CBT interventions for depressed adolescents. The manual for each of the seven COPE sessions is concise, and the COPE intervention is usable in 30-minute sessions. The seven CBT-based skill-building sessions in COPE had been previously embedded into a 15-session healthy life- style intervention for adolescents that was delivered in required high school health courses, but it had not yet been evaluated in a community health setting (Melnyk et al., 2007, 2009). Therefore, the purpose of this EBP change project was to implement and evaluate the outcomes of delivering COPE to teens in a community mental health clinic.

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