Question

Describe CATS model search strategies and results

Answer 1

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:

Purpose

Reviewer

Date of completion

Date for review

Well-built questions

Search strategies and results

Evidence retrieved

Appraisal

Conclusions

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. 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

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

Identify gaps in knowledge 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 using our Physiopedia Template

Other CAT formats and approaches

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

Limitations of CATs

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.

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