Critically Appraised Topics: Difference between revisions
Rachael Lowe (talk | contribs) No edit summary |
Rachael Lowe (talk | contribs) No edit summary |
||
| Line 18: | Line 18: | ||
== Why do we need CATs<br> == | == Why do we need CATs<br> == | ||
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 | 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<ref>Sauvé, S., Lee, H. N., Meade, M. O., Lang, J. D., Farkouh, M., Cook, D. J., &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>. “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<ref>Ziegler, S., Lühmann, D., Raspe, H., & Windeler, J. (2001). Entscheidungsunterstützung durch Kurzstellungnahmen zur Evidenzlage. Zeitschrift für ärztliche Fortbildung und Qualitätssicherung, 95, 105-111.</ref>. <br> | ||
== CATs as part of the EBP process == | == CATs as part of the EBP process == | ||
| Line 41: | Line 41: | ||
*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> == | == 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> == | ||
#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?<br> | ||
#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?<br> | ||
#Is it unlikely that relevant studies were missed?<br> | #Is it unlikely that relevant studies were missed?<br> | ||
#Was the evidence appraised the best available to answer the question?<br> | #Was the evidence appraised the best available to answer the question?<br> | ||
#Were the appropriate validity criteria applied to the evidence appraised?<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> | #Are the dates clearly stated? Date of search, date of publication, date of expiry.<br> | ||
#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?<br> | ||
#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? | ||
<br> | <br> | ||
Revision as of 19:00, 16 March 2011
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.
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
[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. 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[2]. “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[3].
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
[edit | edit source]
- 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[4]
[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
- ↑ Sauvé, S., Lee, H. N., Meade, M. O., Lang, J. D., Farkouh, M., Cook, D. J., &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.
- ↑ Ziegler, S., Lühmann, D., Raspe, H., & Windeler, J. (2001). Entscheidungsunterstützung durch Kurzstellungnahmen zur Evidenzlage. Zeitschrift für ärztliche Fortbildung und Qualitätssicherung, 95, 105-111.
- ↑ Dawes, M. (2005). Critically appraised topics and evidence-based medicine journals. Singapore Medical Journal, 46(9), 442.
