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

Abstract

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.

The qual-CAT: Applying a rapid review approach to qualitative research to support clinical decision-making in speech-language pathology practice

“…A CAT offers a pragmatic approach for examining the evidence base across a focused area, driven by a clinical question. The aim is to identify and rapidly appraise the 'top' literature (White, Raghavendra, & McAllister, 2017). Like other forms of rapid review, the CAT approach restricts the searching component of the review, and simplifies the analysis of studies, while keeping the appraisal rigorous and the overall approach transparent (White et al, 2017).…”

“…The aim is to identify and rapidly appraise the 'top' literature (White, Raghavendra, & McAllister, 2017). Like other forms of rapid review, the CAT approach restricts the searching component of the review, and simplifies the analysis of studies, while keeping the appraisal rigorous and the overall approach transparent (White et al, 2017). This is characterised by Grant and Booth (2009) as a 'quick but not dirty' approach to evidencebased practice.…”

“…The CAT is a useful approach to answer questions that arise about individual clients in a way that is closer to the point of care (Sadigh et al, 2012). Additionally, CATs use less demanding analysis techniques to combine or synthesise findings than systematic reviews, making them more practical for both creating and using in practice (White et al, 2017). The use of CATs in speech-language pathology has been recently discussed and demonstrated (Watt & White, 2018;White et al, 2017), and the approach has been applied successfully by speech pathologists in practice who use this as a practical, relevant approach to understanding the evidence for practice (Kelly, Miles Kingma, & Robinson, 2010).…”

“…Searching in a CAT is systematic, but scaled back. The searcher is not attempting to comprehensively identify all possible articles in an area, but to identify the key research in relation to the clinical question (White et al, 2017). In practice, this means focusing the search on key places that are likely to yield the best evidence.…”

“…In practice, this means focusing the search on key places that are likely to yield the best evidence. For quantitative CATs, starting with secondary (pre-appraised) literature, such as existing systematic reviews or syntheses is recommended (White et al, 2017). This rule applies to qualitative research as well, although databases of pre-appraised evidence or systematic reviews (such as SpeechBITE) do not exist for qualitative research.…”