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== What is a Critically Appraised Topic (CAT)<br> ==
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'''Original Editor '''­ [[User:Rachael Lowe|Rachael Lowe]]


A critically appraised topic (or CAT) is a short summary of evidence on a topic of interest, usually focussed around a clinical question. Defined as a brief “summary of a search and critical appraisal of the literature related to a focused clinical question, which should be kept in an easily accessible place so that it can be used to help make clinical decisions”<ref>Centre for Evidence Based Emergency Medicine, [http://www.ebem.org/definitions.html#Critically%20appraised%20topic http://www.ebem.org/definitions.html#Critically%20appraised%20topic] last accessed 21st March 2011</ref>. <br>  
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}
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== What is a Critically Appraised Topic (CAT)  ==
 
A critically appraised topic (or CAT) is a short summary of evidence on a topic of interest, usually focussed around a clinical question. Defined as a brief “summary of a search and critical appraisal of the literature related to a focused clinical question, which should be kept in an easily accessible place so that it can be used to help make clinical decisions”<ref>Centre for Evidence Based Emergency Medicine, http://www.ebem.org/definitions.html#Critically%20appraised%20topic last accessed 21st March 2011</ref>. <br>  


A CAT is like a shorter and less rigorous version of a systematic review, summarising the best available research evidence on a topic. Usually more than one study is included in a CAT. When professionals summarise a single study, the outcome is a critically appraised paper (or CAP). CATs and CAPs are one way for busy clinicians to collate and share their appraisals.  
A CAT is like a shorter and less rigorous version of a systematic review, summarising the best available research evidence on a topic. Usually more than one study is included in a CAT. When professionals summarise a single study, the outcome is a critically appraised paper (or CAP). CATs and CAPs are one way for busy clinicians to collate and share their appraisals.  


Key parts of a CAT include:<br>
Because they are client-centered and based on “real-life” clinical scenarios, CATs should appeal to clinical learners at all levels.<br>
 
== Key parts of a CAT include: ==


#Purpose<br>  
#Purpose<br>  
#Reviewer<br>  
#Reviewer<br>  
#Date of completion<br>  
#Date of completion<br>  
#Date for review
#Well-built questions<br>  
#Well-built questions<br>  
#Search strategies and results<br>  
#Search strategies and results<br>  
Line 16: Line 26:
#Conclusions<br>
#Conclusions<br>


== Why do we need CATs<br> ==
== Why do we need CATs? ==


It is almost impossible for practitioners to keep up to date with all the new evidence for their field of clinical expertise.&nbsp; Research shows that even seasoned health-care clinicians and practitioners encounter up to 5 “knowledge needs” for every in-patient, and about 2 “needs” for every three out-patients<ref>Sauvé, S., Lee, H. N., Meade, M. O., Lang, J. D., Farkouh, M., Cook, D. J., &amp;amp;amp;amp; Sackett, D.fckLRL. (1995). The critically appraised topic: A practical approach to learning criticalfckLRappraisal. Annales of the Royal College of Physicians and Surgeons of Canada,fckLR28(7), 396-398.</ref>.&nbsp; “Knowledge needs” raise questions about the best course of action.&nbsp; Evidence-based decision making in clinical scenarios demands time-efficient, up-to-date evidence review.&nbsp; Critically appraised summaries of the best evidence for common clinical or educational questions address these needs.&nbsp; “Gold standard” would be a systematic review, but this takes too much time and effort and is not practicable for clinicians<ref>Ziegler, S., Lühmann, D., Raspe, H., &amp;amp; Windeler, J. (2001). Entscheidungsunterstützung durch Kurzstellungnahmen zur Evidenzlage. Zeitschrift für ärztliche Fortbildung und Qualitätssicherung, 95, 105-111.</ref>.&nbsp; <br>  
It is almost impossible for practitioners to keep up to date with all the new evidence for their field of clinical expertise.&nbsp; All practitioners encounter questions that arise from real life clinical situations.&nbsp; Evidence-based decision making in clinical scenarios demands time-efficient, up-to-date evidence review.&nbsp; Critically appraised summaries of the best evidence for common clinical or educational questions address these needs.&nbsp; The gold standard would be a systematic review, but this takes too much time and effort and is not practicable for clinicians.<br>  


== CATs as part of the EBP process  ==
== CATs as part of the EBP process  ==


1. Developing a well-built question<br>2. Search for and select best evidence<br>3. Analyse the evidence - '''Write CAT'''<br>4. Apply the evidence to the clinical situation<br>5. Evaluating the application of the evidence - '''Revise CAT'''<br>6. Disseminating the findings&nbsp; - '''Share CAT'''<br>  
CATs can form a structured part of the EBP process:
 
1. Develop a well-built question<br>2. Search for and select best evidence<br>3. Analyse the evidence - '''Write CAT'''<br>4. Apply the evidence to the clinical situation<br>5. Evaluating the application of the evidence - '''Revise CAT'''<br>6. Disseminating the findings&nbsp; - '''Share CAT'''<br>  


== How to Construct a CAT<br> ==
== How to Construct a CAT  ==


#Identify gaps in knowledge (“knowledge needs”) from client encounters  
#Identify gaps in knowledge from client encounters  
#Translate the problem into an answerable question  
#Translate the problem into an answerable question  
#Formulate a well-built question using the [[PICO Questions|PICO framework]]  
#Formulate a well-built question using the [[Formulating Clinical Questions|PICO framework]]  
#Search for the [[Find the best available evidence|best available evidence]]<br>  
#Search for the [[Find the best available evidence|best available evidence]]<br>  
#Examine and critically appraise the evidence<br>  
#Examine and critically appraise the evidence<br>  
#Write the CAT<br>
#Write the CAT using our Physiopedia [[Template:CAT|Template]]<br>  
#Share the CAT here on Physiopedia<br>


== Other CAT formats and approaches  ==
== Other CAT formats and approaches  ==
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*Appraise a recently published article that is important; or summarize an article used to provide evidence as part of a guideline
*Appraise a recently published article that is important; or summarize an article used to provide evidence as part of a guideline


== Validation Criteria for CATs<ref name="Dawes">Dawes, M. (2005). Critically appraised topics and evidence-based medicine journals. Singapore Medical Journal, 46(9), 442.</ref><br>  ==
== Validation Criteria for CATs<ref name="Dawes">Dawes, M. (2005). Critically appraised topics and evidence-based medicine journals. Singapore Medical Journal, 46(9), 442.</ref>   ==


#Is the CAT valid?  
#Is the CAT valid?  
#Was the CAT focused by a well-built question?<br>
#Was the CAT focused by a well-built question?
#What was the explicit and sensible process used to identify and select the evidence?<br>
#What was the explicit and sensible process used to identify and select the evidence?
#Is it unlikely that relevant studies were missed?<br>
#Is it unlikely that relevant studies were missed?
#Was the evidence appraised the best available to answer the question?<br>
#Was the evidence appraised the best available to answer the question?
#Were the appropriate validity criteria applied to the evidence appraised?<br>
#Were the appropriate validity criteria applied to the evidence appraised?
#Are the dates clearly stated? Date of search, date of publication, date of expiry.<br>
#Are the dates clearly stated? Date of search, date of publication, date of expiry.
#What is the CAT’s message?  
#What is the CAT’s message?  
#How strong is the message? Is it expressed in terms likely to be helpful in clinical management?  
#How strong is the message? Is it expressed in terms likely to be helpful in clinical management?  
#Will the CAT’s message help me in the care of my clients?  
#Will the CAT’s message help me in the care of my clients?  
#Can I apply the message in my client setting, to my clients?  
#Can I apply the message in my client setting, to my clients?  
#Were all clinically important outcomes, benefits, harms and costs discussed?<br>
#Were all clinically important outcomes, benefits, harms and costs discussed?  
#Is the academic or training level of the authors or commentators clearly stated?  
#Is the academic or training level of the authors or commentators clearly stated?  
#Have the authors, site developers, and sponsors disclosed all competing interests?  
#Have the authors, site developers, and sponsors disclosed all competing interests?  
#Is there a mechanism to contact the authors?
#Is there a mechanism to contact the authors?


== Limitations of CATs<br> ==
== Limitations of CATs ==
 
*Individual CATs can be wrong or inaccurate<br>
 
CATs appear first as drafts without peer review.&nbsp; These first drafts may contain inferior evidence, or errors of fact, calculations, or interpretation. Can be turned into educational benefit: revise CATs in group discussions with clinicians or in other educational eventsIndividual CATs <br>


*Individual CATs may have a short shelf life
Individual CATs can be wrong or inaccurate.&nbsp; CATs appear first as drafts without peer review.&nbsp; These first drafts may contain inferior evidence, or errors of fact, calculations, or interpretation. This can be turned into educational benefit whereby CATs can be revised in clinical or student projects.<br>


Cats can become obsolete as soon as newer, better evidence becomes available.&nbsp; Without constant updating for newer, better evidence, their clinical bottom line becomes out of date.&nbsp; Good quality CATs specify update or “expiration” dates after which they should be considered obsolete<br>
Individual CATs may have a short shelf life.&nbsp; Cats can become obsolete as soon as newer, better evidence becomes available.&nbsp; Without constant updating for newer, better evidence, their clinical bottom line becomes out of date.&nbsp; Good quality CATs specify update date.<br>  


*Individual, “one-article” CATs contain only a single element of the relevant research literature
Individual, one-article CATs contain only a single element of the relevant research literature.&nbsp; These critically appraised papers (CAPs) are not comprehensive explorations for all useful articles and non-representative of the entire body of evidence.
== References ==


These CATs are not comprehensive explorations for all useful articles.&nbsp; Non-representative of the entire body of evidence<br>
<references /><br>  


<br>
[[Category:EBP]]

Latest revision as of 00:04, 25 May 2021


What is a Critically Appraised Topic (CAT)[edit | edit source]

A critically appraised topic (or CAT) is a short summary of evidence on a topic of interest, usually focussed around a clinical question. Defined as a brief “summary of a search and critical appraisal of the literature related to a focused clinical question, which should be kept in an easily accessible place so that it can be used to help make clinical decisions”[1].

A CAT is like a shorter and less rigorous version of a systematic review, summarising the best available research evidence on a topic. Usually more than one study is included in a CAT. When professionals summarise a single study, the outcome is a critically appraised paper (or CAP). CATs and CAPs are one way for busy clinicians to collate and share their appraisals.

Because they are client-centered and based on “real-life” clinical scenarios, CATs should appeal to clinical learners at all levels.

Key parts of a CAT include:[edit | edit source]

  1. Purpose
  2. Reviewer
  3. Date of completion
  4. Date for review
  5. Well-built questions
  6. Search strategies and results
  7. Evidence retrieved
  8. Appraisal
  9. Conclusions

Why do we need CATs?[edit | edit source]

It is almost impossible for practitioners to keep up to date with all the new evidence for their field of clinical expertise.  All practitioners encounter questions that arise from real life clinical situations.  Evidence-based decision making in clinical scenarios demands time-efficient, up-to-date evidence review.  Critically appraised summaries of the best evidence for common clinical or educational questions address these needs.  The gold standard would be a systematic review, but this takes too much time and effort and is not practicable for clinicians.

CATs as part of the EBP process[edit | edit source]

CATs can form a structured part of the EBP process:

1. Develop a well-built question
2. Search for and select best evidence
3. Analyse the evidence - Write CAT
4. Apply the evidence to the clinical situation
5. Evaluating the application of the evidence - Revise CAT
6. Disseminating the findings  - Share CAT

How to Construct a CAT[edit | edit source]

  1. Identify gaps in knowledge from client encounters
  2. Translate the problem into an answerable question
  3. Formulate a well-built question using the PICO framework
  4. Search for the best available evidence
  5. Examine and critically appraise the evidence
  6. Write the CAT using our Physiopedia Template

Other CAT formats and approaches[edit | edit source]

There are other different purposes of producing CATs which include:

  • Answer explicit clinical question from real clinical situation.  This is the essence of EBP.
  • Appraise a recently published article that is important; or summarize an article used to provide evidence as part of a guideline

Validation Criteria for CATs[2][edit | edit source]

  1. Is the CAT valid?
  2. Was the CAT focused by a well-built question?
  3. What was the explicit and sensible process used to identify and select the evidence?
  4. Is it unlikely that relevant studies were missed?
  5. Was the evidence appraised the best available to answer the question?
  6. Were the appropriate validity criteria applied to the evidence appraised?
  7. Are the dates clearly stated? Date of search, date of publication, date of expiry.
  8. What is the CAT’s message?
  9. How strong is the message? Is it expressed in terms likely to be helpful in clinical management?
  10. Will the CAT’s message help me in the care of my clients?
  11. Can I apply the message in my client setting, to my clients?
  12. Were all clinically important outcomes, benefits, harms and costs discussed?
  13. Is the academic or training level of the authors or commentators clearly stated?
  14. Have the authors, site developers, and sponsors disclosed all competing interests?
  15. Is there a mechanism to contact the authors?

Limitations of CATs[edit | edit source]

Individual CATs can be wrong or inaccurate.  CATs appear first as drafts without peer review.  These first drafts may contain inferior evidence, or errors of fact, calculations, or interpretation. This can be turned into educational benefit whereby CATs can be revised in clinical or student projects.

Individual CATs may have a short shelf life.  Cats can become obsolete as soon as newer, better evidence becomes available.  Without constant updating for newer, better evidence, their clinical bottom line becomes out of date.  Good quality CATs specify update date.

Individual, one-article CATs contain only a single element of the relevant research literature.  These critically appraised papers (CAPs) are not comprehensive explorations for all useful articles and non-representative of the entire body of evidence.

References[edit | edit source]

  1. Centre for Evidence Based Emergency Medicine, http://www.ebem.org/definitions.html#Critically%20appraised%20topic last accessed 21st March 2011
  2. Dawes, M. (2005). Critically appraised topics and evidence-based medicine journals. Singapore Medical Journal, 46(9), 442.