Critically Appraised Topics Research Articles

Promoting evidence-based practice and nursing excellence: How involvement in a Magnet4Europe® research study led to development of critically appraised topics sessions for health care staff.

Gloucestershire Hospitals NHS Foundation Trust (GHNHSFT) is actively participating in the Magnet4Europe® research study, which aims to advance nursing excellence and promote evidence-based practice. As part of this initiative, the Nursing, Allied Health Professional and Midwifery Research Council at GHNHSFT has been actively engaging colleagues in evidence-based practice and research. This has been achieved through the development of sessions using the Critically Appraised Topics (CATs) framework, where clinical questions and relevant research articles are discussed. This article describes the collaborative approach between the Lead Nurse for Continual Professional Development and the Deputy Manager of the Library and Knowledge Services to develop and run the sessions. Collaboration between clinical staff and library and knowledge teams can be useful in encouraging healthcare professionals' engagement with the evidence base in order to consider changes to practice.

Critically Appraised Topics (CATs) in Veterinary Medicine: Applying Evidence in Clinical Practice.

Critically appraised topics (CATs) are evidence syntheses that provide veterinary professionals with information to rapidly address clinical questions and support the practice of evidence-based veterinary medicine (EBVM). They also have an important role to play in both undergraduate and post-registration education of veterinary professionals, in research and knowledge gap identification, literature scoping, preparing research grants and informing policy. CATs are not without limitations, the primary one relating to the rapid approach used which may lead to selection bias or restrict information identified or retrieved. Furthermore, the narrow focus of CATs may limit applicability of the evidence findings beyond a specific clinical scenario, and infrequently updated CATs may become redundant. Despite these limitations, CATs are fundamental to EBVM in the veterinary profession. Using the example of a dog with osteoarthritis, the five steps involved in creating and applying a CAT to clinical practice are outlined, with an emphasis on clinical relevance and practicalities. Finally, potential future developments for CATs and their role in EBVM, and the education of veterinary professionals are discussed. This review is focused on critically appraised topics (CATs) as a form of evidence synthesis in veterinary medicine. It aims to be a primary guide for veterinarians, from students to clinicians, and for veterinary nurses and technicians (hereafter collectively called veterinary professionals). Additionally, this review provides further information for those with some experience of CATs who would like to better understand the historic context and process, including further detail on more advanced concepts. This more detailed information will appear in pop-out boxes with a double-lined surround to distinguish it from the information core to producing and interpreting CATs, and from the boxes with a single line surround which contain additional resources relevant to the different parts of the review.

What do parents think about their involvement in speech-language pathology intervention? A qualitative critically appraised topic

A critically appraised topic (CAT) is one form of rapid review that can be particularly useful for informing practice. The purpose of this CAT was to determine what caregivers of preschool-aged children with speech, language or communication disorders (2–5 years of age) think of their involvement in speech-language pathology intervention in community-based settings. In addition to this CAT, the authors present and discuss a methodology for qualitative critically appraised topics (this issue). The authors propose an update to this CAT in June 2021.

Prosthodontic management of children with ectodermal dysplasia: A literature review

Introduction Ectodermal dysplasia (ED) is a large group of heterogeneous heritable conditions characterized by congenital defects of two or more ectodermal structures and their appendages. The diagnosis of ED in early infancy period may be difficult in that sparse hair and absent teeth are normal findings at this stage of development. However, characteristic deformities of the skull including the square aspect of the forehead; frontal bossing; sunken cheeks; hyperpigmentation of the periorbital skin; prominent supraorbital ridges; saddle nose; and hypoplastic-appearing alaque nasi helps in diagnosing ED cases. In addition to its other symptoms, the dental characteristics of this syndrome include number anomalies such as anodontia or severe hypodontia (with or without a cleft lip and palate) that is associated with lack of alveolar ridge development and reduced vertical dimension. Clinically there are two major types of ED namely hidrotic and anhidrotic (hypohidrotic form). The hypohidrotic form is most common type with an incidence estimated to be 1–7 per 10,000 live births. The goals of dental treatment for individuals affected by the ED syndromes are to provide an age-appropriate dentition that optimizes function, facial development, speech and esthetics. Dental management of children with ectodermal dysplasia includes removable, fixed and implant prosthesis. Materials and Method A computerized search of the literature was done by searching the web based databases PubMed, Up To Date and the University of Texas Health Science Center for Critically Appraised Topics (CATS) library for key words including: Ectodermal Dysplasia, Prosthodontic Management of Ectodermal Dysplasia, Oral Manifestations of Ectodermal Dysplasia and Fixed and Removable Prosthodontic Management of Ectodermal Dysplasia. Titles and abstracts of the studies were evaluated according to relevance after obtaining the full text articles. The search ended in January 2017. The inclusion criteria were: studies that evaluated different modalities of treatment of ectodermal dysplasia, studies that addressed the effects of ectodermal dysplasia on oral health, reviews that addressed the clinical consequences of ectodermal dysplasia, case reports and case series of ectodermal dysplasia. Exclusion criteria: studies that were directed or focused to other aspects of ectodermal dysplasia other than oral health. Results These patients often need a multidisciplinary approach to treatment planning and dental treatment to regain esthetics and function of the stomatognathic system. Considering the age, different rehabilitation options can be considered, from classic conventional solutions such as complete denture, removable partial denture, overdentures and to the most up to date implant supported prosthetics. Conclusion Recall every 6 months with possible relining, rebasing or making a new denture. Following growth completion and occlusion stabilization an implant retained removable or fixed denture can be used to replace the missing teeth permanently. Moreover, traditional removable denture can be an option for replacing the missing teeth. However, implants provide the best long term results and prognosis.

The effectiveness of telemedicine on stigmatization and treatment burden in patients with health compromising lifestyles and chronic diseases: A critically appraised topic

Objectives: To conduct a critical appraisal of peer reviewed articles on the effectiveness of telemedicine on stigmatization and treatment burden in patients with health compromising lifestyles and chronic diseases.Methods: This study critically appraised peer-reviewed article on the effectiveness of telemedicine on stigmatization and treatment burden in patients with health compromising lifestyles and chronic diseases. Treatments included e-health interventions, information and communication technologies used in health care, internet-based interventions for diagnosis and treatments that encouraged collaborative care for patients with chronic diseases. This paper critically appraised the full text of each relevant peer-reviewed article adapting the Occupational Therapy Critically Appraised Topics (CATs) template while using the Oxford Centre for Evidence-based Medicine- Levels of Evidence (2011) model to assess for best evidence or quality. Results: Initial internet search using Psychinformation; PubMed; Medline; ProQuest; CINAHL; OT seeker and the Cochrane Library generated over 1450 titles/abstracts. Following abstract appraisal, 30 articles were selected for full text assessment. Five of the final articles selected for this critical appraisal alluded to the effectiveness of telemedicine in reducing the treatment burden of stigmatization on patients with chronic diseases. Majority of the appraised articles indicated the effectiveness of telemedicine in changing behaviours.Conclusions: All the appraised articles alluded to the effectiveness of telemedicine in curbing some of the treatment burdens of stigmatization for patients with health compromising lifestyles and chronic diseases. However, it is evident that the use of other intervention methods such as government policy, public education and patient empowerment in conjunction with telemedicine would better reduce the effect of stigmatization and facilitate the medical interventions for patients with chronic diseases.

How to write a Critically Appraised Topic: evidence to underpin routine clinical practice

Critically appraised topics (CATs) are essential tools for busy clinicians who wish to ensure that their daily clinical practice is underpinned by evidence-based medicine. CATs are short summaries of the most up-to-date, high-quality available evidence that is found using thorough structured methods. They can be used to answer specific, patient-orientated questions that arise recurrently in real-life practice. This article provides readers with a detailed guide to performing their own CATs. It is split into four main sections reflecting the four main steps involved in performing a CAT: formulation of a focused question, a search for the most relevant and highest-quality evidence, critical appraisal of the evidence and application of the results back to the patient scenario. As well as helping to improve patient care on an individual basis by answering specific clinical questions that arise, CATs can help spread and share knowledge with colleagues on an international level through publication in the evidence-based dermatology section of the British Journal of Dermatology.

Evaluation of a CAT Database and Expert Appraisal of CATs Developed by Students.

Five steps have been recommended to provide evidence-based patient care: formulating a clinical question, searching for literature, evaluating the validity and applicability of results, implementing results into practice, and assessing if the new evidence has led to improved health care. Students can be trained in these steps by the development of knowledge summaries such as critically appraised topics (CATs). The aim of the present project was the development, use, and evaluation of a German-language CAT database and an appraisal of the quality of CATs developed by students. A total of 153 fifth-year veterinary medical students (in 21 groups) were enrolled in the project. Each group developed a CAT and most students participated in a survey. To learn more about the quality of the CATs, we asked experts to appraise the texts written by the students. The CATs were indexed with key words and assigned to specific fields corresponding to the European Colleges of Veterinary Specialisation. Currently, 57 CATs have been developed. The majority of students stated that writing CATs is a good exercise and that "it is important to teach the assessment of scientific information." In total, 13 experts completed the questionnaires, out of which 9 graded the CAT they appraised as good. In addition to English-language CAT databases, German tools should also be available for students and practitioners.

Oral Health Critically Appraised Topics (CATs)

Oral Health Critically Appraised Topics (CATs)

Letting the CAT out of the bag: Contribution of critically appraised topics to evidence-based practice

Locating the best available research, critically appraising it and synthesizing the findings with evidence from practice and the wishes of the service user and/or their advocate(s) is central to providing high-quality services to people with communication impairments. Determining whether research evidence is high quality, recent, and relevant is a particular challenge for practitioners. Knowledge translation strategies such as providing critical appraisals of research and advice on how to apply the findings provide useful support to the decision-making process. There are a number of formats that provide critical appraisals of research, the most familiar being systematic reviews, critically appraised papers, and rapid reviews. A critically appraised topic (CAT) is one form of rapid review that can be particularly useful for informing practice in a rich and nuanced manner. We will discuss the features of CATs along with similarities and differences to systematic reviews, critically appraised papers, and other types of rapid reviews. Additionally, we will provide guidance on how to conduct a CAT, present the information, and use it to support high-quality communication assessment and intervention practice.

Oral Health Critically Appraised Topics (CATs)

Oral Health Critically Appraised Topics (CATs)

Pharmacological interventions on early functional gastrointestinal disorders.

BackgroundFunctional gastrointestinal disorders (FGIDs) are chronic or recurrent gastrointestinal symptoms without structural or biochemical abnormalities. FGIDs are multifactorial conditions with different pathophysiologic mechanisms including altered motility, visceral hyperalgesia, brain-gut disturbance, genetic, environmental and psychological factors.Although in most cases gastrointestinal symptoms are transient and with spontaneous resolution in infancy multiple dietary changes and pharmacological therapy are often started despite a lack of evidence-based data. Our aim was to update and critically review the current literature to assess the effects and the clinical appropriateness of drug treatment in early (occurring in infants and toddlers) FGIDs.MethodsWe systematically searched the Medline and GIMBE (Italian Group on Medicine Based on Evidence) databases, according to the methodology of the Critically Appraised Topics (CATs). We included reviews, clinical studies, and evidence-based guidelines reporting on pharmacological treatments. Systematic reviews and randomized controlled trials (RCTs) concerning pharmacologic therapies in children with early FGIDs were included, and data were extracted on participants, interventions, and outcomes.ResultsWe found no evidence-based guidelines or systematic reviews about the utility of pharmacological therapy in functional regurgitation, infant colic and functional diarrhea. In case of regurgitation associated with marked distress, some evidences support a short trial with alginate when other non pharmacological approach failed (stepped-care approach). In constipated infants younger than 6 months of age Lactulose is recommended, whilst in older ages Polyethylene glycol (PEG) represents the first-line therapy both for fecal disimpaction and maintenance therapy of constipation. Conversely, no evidence supports the use of laxatives for dyschezia. Furthermore, we found no RCTs regarding the pharmacological treatment of cyclic vomiting syndrome, but retrospective studies showed a high percentage of clinical response using cyproheptadine, propanolol and pizotifen.ConclusionThere is some evidence that a pharmacological intervention is necessary for rectal disimpaction in childhood constipation and that PEG is the first line therapy. In contrast, for the other early FGIDs there is a lack of well-designed high-quality RCTs and no evidence on the use of pharmacological therapy was found.

Oral Health Critically Appraised Topics (CATs)

Oral Health Critically Appraised Topics (CATs)

Oral Health Critically Appraised Topics (CATs)

Oral Health Critically Appraised Topics (CATs)

Finding Up-to-Date Answers for Focused Clinical Problems: The UT Critically Appraised Topics (CATs) Library

Finding Up-to-Date Answers for Focused Clinical Problems: The UT Critically Appraised Topics (CATs) Library

Oral Health Critically Appraised Topics (CATs)

Oral Health Critically Appraised Topics (CATs)

Concept mapping as a method to teach an evidence-based educated medical topic: a comparative study in medical students.

BackgroundThe objective of this study was to compare concept mapping with lecture-based method in teaching of evidence based educated topic to medical students.MethodsThis randomized controlled trial was carried out on medical students during sixth year of 7-year MD curriculum clerkship phase. Cluster randomization was used to divide students into intervention and control groups. Both groups, at the beginning, were taught “Diabetic Ketoacidosis” (DKA) using evidence-based tool named Critically Appraised Topics (CAT). Students of intervention group were taught construction of concept maps on DKA and in the control group students had a lecture and a group discussion about what they had been taught on DKA. In the end, all of the students had an exam that they had to answer to 7 questions following to two clinical scenarios. The questions addressed physiopathology, diagnosis and treatment of patients with DKA and were scored separately. Sum of these scores was considered as total score. Scores were compared between intervention and control groups.ResultsSeventy six medical students (28 male, 48 female) were participated in this study. Total score among intervention group was higher than control group (78.2% vs. 72.5%, p < 0.001). Subgroup analysis revealed significant differences between scores of students in the intervention group and scores of students in the control group in the diagnostic section of questions (81.0% vs. 71.5%, P < 0.001). The scores of students in the intervention group were also significantly higher than control group in physiopathology section of questions. No statistically significant difference was discovered between two groups in scores of answers to treatment section of questions (78.1 (7.3) vs. 72.5 (5.5) P = 0.03).ConclusionThe results of the study showed that concept mapping method was more successful in education of evidence-based educated topic via CATs in comparison with lecture-based method. Interpretation of this finding would be the concept mapping method may develop meaningful learning among medical students.

Los 6 pasos necesarios para elaborar Critically Appraised Topics

Different types of critically appraised topics (CATs) can be elaborated in diagnostic imaging: comparison of diagnostic tests, evaluation of techniques for early detection (screening), economical analyses, or therapeutic aspects, among others. Their design will vary in function of the question they aim to answer. For example, for treatment evaluation, clinical trials are the best, but if there are secondary studies (systematic reviews or meta-analyses) that synthesize information from several studies, the results will be more important and the scientific conclusions will be more relevant. Regardless of the study design used, the elaboration of a CAT will involve six steps: 1) question; 2) systematic and efficient bibliographic search; 3) levels of evidence (choosing the articles that have the best level); 4) critical reading of the articles chosen; 5) applying conclusions to the context, and 6) recommendations. In this article, we will describe these steps and the nuances for different types of studies in each step.

Critically Appraised Topics: una nueva oportunidad de publicación en Radiología

Physicians need fast access to quality information about the best diagnostic tests and treatments in each case. To meet this need, a new publishing format has emerged. Critically appraised topics (CATs) are elaborated following the five steps of evidence-based medicine. CATs are structured summaries of research articles that deal with a specific clinical query, presenting a critical evaluation of the best evidence available to support the validity of the available options. CATs have proven useful in teaching evidence-based radiology and this publishing format is becoming more common. Radiology CATs can be found on medical websites and in journals, including those dedicated to general medicine as well as those specifically dedicated to radiology. Radiología encourages the publication of CATs because we consider that they can be useful for daily decision making.

Training Evidence-Based Veterinary Medicine by Collaborative Development of Critically Appraised Topics

In current veterinary education, skills such as retrieving, critically appraising, interpreting, and applying the results of published scientific studies are rarely taught. In this study, the authors tested the concept of team-based development of critically appraised topics (CATs) in training students in evidence-based veterinary medicine (EBVM). The 116 participants were in their fifth year and attending the clinical rotation at the Clinic for Animal Reproduction. Students developed 18 CATs of varying quality on topics of their choice. Preparing the CATs in teams stimulated discussion on the topic and the quality of the retrieved papers. Evaluation of the project revealed that more than 90% of the students endorsed training in critical appraisal of information in veterinary education. In addition, more than 90% considered the development of CATs an effective exercise for assessing the quality of scientific literature. A provided literature evaluation form was perceived as a useful tool for systematically summarizing a publication's quality. In conclusion, team-based development of CATs during clinical rotations is highly valuable for training in EBVM. Learning and intrinsic motivation seem to be enhanced by creating a situation similar to veterinary practice because the task is embedded into an authentic clinical problem. This approach to clinical training helps to prepare students to integrate evidence from literature into practice.

Resources to help occupational therapists access and appraise research evidence: progress from Australia

Evidence-based practice has stimulated the need for occupational therapists to access, interpret and integrate information from research in their clinical decisions. Yet the skills and time required to do so have presented significant challenges to busy clinicians. Concerted efforts have therefore been made by many occupational therapy professional groups, organisations, researchers, academics and clinicians to develop resources to support therapists’ access to, interpretation and communication of research information. Over the last decade, Australian occupational therapists have been at the forefront of endeavours to develop resources to facilitate evidence-based occupational therapy. This paper aims to describe the development and progress of three important resources to support evidence based practice: Critically Appraised Papers (CAPS), Critically Appraised Topics (CATS), and the OTseeker database (www.otseeker.com). These resources provide free access to research that has been both screened for relevance and critically appraised, assisting therapists worldwide to engage in evidence-based practice.