The opening paragraph should be a substantive description of the issue as a lead into your PICOT question. This section ends with the PICOT question.Discussion and Synthesis of EvidenceAlthough only 5 sources of evidence are required, the evidence will serve as a basis to change practice. Thus, the quality of the evidence selected is paramount. The connection between the PICOT question and the external evidence should be clear and compelling. Please refer to the hierarchy of evidence delineated in Box 1.3. The narrative summary should synthesize the external evidence with a cogent discussion of similarities and dissimilarities. Accompanying the narrative is a synthesis table. A range of formats for the synthesis table are provided in the text.