Please refer to your Learnonline course site for full assessment instructions and the marking rubric.
Critically Appraised Topics (or CATs) are like miniature systematic reviews and are the preferred format for your assignment. This guide walks you through the process of completing a Critically Appraised Topic, following a few key steps:
Ask (formulate a clinical question)
Access (design and construct a search)
Appraise (assess each study's suitability)
Apply (respond to the clinical question, using the evidence)
Need an examplar? View a Critically Appraised Topic from the American Occupational Therapy Association (AOTA).
The PICO framework is useful for making sense of your clinical scenario and helping to turn it into a question.
A 68 year old woman has been instructed to undertake yoga to maintain physical fitness. She asks if playing the Nintendo Wii, which she enjoys, is a suitable alternative.
Population / Patient
|I / E||
Intervention / Exposure
Comparator / Comparison
Now use the PICO breakdown to formulate an answerable, focused question:
So for our example, the question becomes:
Hint: This assignment suggests that you use an effectiveness question, however you are free to ask a different type of EBP question if you prefer.
The next step is to conduct a thorough, reproducible search of the evidence. To do this well, consider the specific scope for your search, such as the:
Level of Evidence/Study Designs to be included (Random Control Trials etc)
Inclusion / Exclusion Criteria:
Minutia of your PICO (eg, Participants: women only etc)
Context (region / setting) or limits**
Alternative terms for each PICO element (these will become your keywords)
** When performing a search, do not add limits (such as publication dates or English language) unless discussed with your tutor. Never apply the 'full text only' link, as this will exclude results which we may hold in another database.
As a rule, use Medline to start building your search.
You should search both keywords and Medical Subject Headings (MeSH), working through each PICO element one at a time.
For each PICO element:
Combine all of your "Set lines" (eg line 3 in the above) with AND. This will find results addressing all your PICO elements.
Hint: You generally do not need to search for your outcome, but if you do, remain unbiased! For example, do not search for "reduced pain", -just search for 'pain', so that you also find papers where a reduction was not the result.
To maintain the transparency and reproducibility of your review, run the same search on each database -changed only as much as necessary to get it to work correctly.
Typically, this means checking truncation, wildcards and phrases. But if you have used subject headings (eg MeSH), you will need to check these too.
Before you start extracting the data from your studies, you need to undertake Critical Appraisal, using an approved "Critical Appraisal Tool'.
UniSA's Dr Savana Kumar explains:
You are now ready to write your review. Consult your Course Workbook for a full list of the headings within your review, and the requirements therein, but be sure to include:
You must include a CONSORT flow diagram to illustrate the progress of studies through your review.
Be sure to record each search, including:
Hint: It's a good idea to capture the search as it was run. Take a screenshot, or use the Windows Snipping tool to capture your search history.
A Clinical Bottom Line
This is a statement that explains how the evidence can -and whether it should- be translated into practice.
It should include:
The below video from the Board of Certification for Athletic Trainers in the US explains more: