Critically Appraised Topics: Difference between revisions
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#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 [[PICO Questions|PICO framework]] | ||
#Search for the [[ | #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<br> | ||
#Share the CAT here on Physiopedia<br> | #Share the CAT here on Physiopedia<br> | ||
== Other CAT formats and approaches == | == Other CAT formats and approaches == | ||
There are other different purposes of producing CATs which include: | There are other different purposes of producing CATs which include: | ||
*Answer explicit clinical question from real clinical situation. This is the essence of EBP. | *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 | *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<br> == | |||
#Is the CAT valid? | |||
#Was the CAT focused by a well-built question?<br> | |||
#What was the explicit and sensible process used to identify and select the evidence?<br> | |||
#Is it unlikely that relevant studies were missed?<br> | |||
#Was the evidence appraised the best available to answer the question?<br> | |||
#Were the appropriate validity criteria applied to the evidence appraised?<br> | |||
#Are the dates clearly stated? Date of search, date of publication, date of expiry.<br> | |||
#What is the CAT’s message? | |||
#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? | |||
#Can I apply the message in my client setting, to my clients? | |||
#Were all clinically important outcomes, benefits, harms and costs discussed?<br> | |||
#Is the academic or training level of the authors or commentators clearly stated? | |||
#Have the authors, site developers, and sponsors disclosed all competing interests? | |||
#Is there a mechanism to contact the authors? | |||
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Revision as of 18:57, 16 March 2011
What is a Critically Appraised Topic (CAT)
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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.
Key parts of a CAT include:
- Purpose
- Reviewer
- Date of completion
- Well-built questions
- Search strategies and results
- Evidence retrieved
- Appraisal
- Conclusions
Why do we need CATs
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It is almost impossible for practitioners to keep up to date with all the new evidence for their field of clinical expertise. 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 (Sauvé, 1995). “Knowledge needs” raise questions about the best course of action. 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. “Gold standard” would be a systematic review, but this takes too much time and effort and is not practicable for clinicians (Ziegler et al., 2001).
CATs as part of the EBP process[edit | edit source]
1. Developing 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
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- Identify gaps in knowledge (“knowledge needs”) from client encounters
- Translate the problem into an answerable question
- Formulate a well-built question using the PICO framework
- Search for the best available evidence
- Examine and critically appraise the evidence
- Write the CAT
- Share the CAT here on Physiopedia
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
[edit | edit source]
- Is the CAT valid?
- Was the CAT focused by a well-built question?
- What was the explicit and sensible process used to identify and select the evidence?
- Is it unlikely that relevant studies were missed?
- Was the evidence appraised the best available to answer the question?
- Were the appropriate validity criteria applied to the evidence appraised?
- Are the dates clearly stated? Date of search, date of publication, date of expiry.
- What is the CAT’s message?
- 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?
- Can I apply the message in my client setting, to my clients?
- Were all clinically important outcomes, benefits, harms and costs discussed?
- Is the academic or training level of the authors or commentators clearly stated?
- Have the authors, site developers, and sponsors disclosed all competing interests?
- Is there a mechanism to contact the authors?
- ↑ Centre for Evidence Based Emergency Medicine, http://www.ebem.org/definitions.html#Critically%20appraised%20topic last accessed 21st March 2011