Abstract
The critically appraised topic (CAT) is a format in evidence-based practice for sharing information. A CAT is a standardized way of summarizing the most current research evidence focused on a pertinent clinical question. Its aim is to provide both a critique of the most up-to-date retrieved research and an indication of the clinical relevance of results. A clinical question is initially generated following a patient encounter, which leads to and directs a literature search to answer the clinical question. Studies obtained from the literature search are assigned a level of evidence. This allows the most valid and relevant articles to be selected and to be critically appraised. The results are summarized, and this information is translated into clinically useful procedures and processes.
Similar content being viewed by others
References
Dawes M (2005) Critically appraised topics and evidence-based medicine journals. Singap Med J 46:442–448, quiz 449
Fetters L, Figueiredo EM, Keane-Miller D et al (2004) Critically appraised topics. Pediatr Phys Ther 16:19–21
Wendt O (2006) Developing critically appraised topics (CATs). Presented at the American Speech-Language Hearing Association, division 12: augmentative and alternative communication (DAAC), 7th annual conference, San Antonio. http://www.edst.purdue.edu/aac/Developing%20Critically%20Appraised%20Topics.pdf. Accessed 29 Aug 2014
Razavi SA, Sadigh G, Kelly AM et al (2012) Comparative effectiveness of imaging modalities for the diagnosis of upper and lower urinary tract malignancy: a critically appraised topic. Acad Radiol 19:1134–1140
Sadigh G, Applegate KE, Baumgarten DA (2014) Comparative accuracy of intravenous contrast-enhanced CT versus noncontrast CT plus intravenous contrast-enhanced CT in the detection and characterization of patients with hypervascular liver metastases: a critically appraised topic. Acad Radiol 21:113–125
Glasziou P, Del Mar C, Salisbury J (2007) EBP Step 1: formulate an answerable question. In: Evidence-based practice workbook, 2nd edn. Blackwell Publishing, Oxford, pp 21–34
Staunton M (2007) Evidence-based radiology: steps 1 and 2—asking answerable questions and searching for evidence. Radiology 242:23–31
Feussner JR, Matchar DB (1988) When and how to study the carotid arteries. Ann Int Med 109:805–818
Haynes RB (2001) Of studies, summaries, synopses, and systems: the ‘4S’ evolution of services for finding current best evidence. Evid Based Ment Health 4:37–39
Haynes RB (2000) Wolters Kluwer Ovid SP. Medline. http://gateway.ovid.com/. Accessed 29 June 2009
Haynes RB (2014) Google and Google Scholar Beta search engines. http://www.google.com/ and http://scholar.google.com/. Accessed 29 June 2009
Haynes RB (2014) NCBI Pubmed Web site. U.S. National Library of Medicine. http://www.ncbi.nlm.nih.gov/PubMed. Accessed 3 May 2010
Haynes RB (2014) ISI Web of Knowledge Web site. Thomson Reuters. www.isiknowledge.com. Accessed 3 May 2010
Haynes RB (2014) MD Consult Web site. Elsevier. www.mdconsult.com. Accessed 3 May 2010
Haynes RB (2014) EMBASE. EMBASE biomedical answers Web site. Elsevier. http://www.embase.com/home. Accessed 3 May 2010
Haynes RB (2014) ARRS GoldMiner. Biomedical images database. goldminer.arrs.org/about.php. Accessed 17 July 2014
Haynes RB (2014) Yottalook Web site. Yottalook medical image search engine. http://www.yottalook.com/index_web.php. Accessed 29 September 2014
Haynes RB (2014) The Cochrane Collaboration Web site. The Cochrane Library. http://www.cochrane.org. Accessed 3 May 2010
Haynes RB (2014) Cochrane central register of controlled clinical trials. The Cochrane Library. www.mrw.interscience.wiley.com/cochrane/cochrane_clcentral_articles_fs.html. Accessed 30 June 2014
Haynes RB (2014) Database of abstracts of reviews of effects. The Cochrane Library. www.mrw.interscience.wiley.com/cochrane/cochrane_cldare_articles_fs.html. Accessed 30 June 2014
Haynes RB (2014) NICE National Institute for Health and Care Excellence Web site. http://www.nice.org.uk/. Accessed 30 June 2009
Haynes RB (2014) Scottish Intercollegiate Guidelines Network (SIGN). http://www.sign.ac.uk/. Accessed 30 June 2009
Haynes RB (2014) National Guidelines Clearinghouse (NGC). U.S. Department of Health & Human Services. http://www.guideline.gov/. Accessed 17 Dec 2010
Haynes RB (2011) National Library for Health (NLH) Web site. The National Archives. www.connectingforhealth.nhs.uk/resources/systserv/national. Accessed 29 June 2014
Kelly AM (2009) Evidence-based radiology: step 2—searching the literature (search). Semin Roentgenol 44:147–152
Kelly AM (1994) Bandolier electronic journal. http://www.medicine.ox.ac.uk/bandolier/aboutus.html. Accessed 1 July 2009
Kelly AM (2014) UpToDate Online. Wolters Kluwer Health. http://www.uptodate.com/home/index.html. Accessed 1 July 2009
Kelly AM (2014) DynaMed clinical reference tool. EBSCO. http://www.ebscohost.com/dynamed/. Accessed 1 July 2009
Kelly AM (2014) Evidence-Based Medicine. BMJ Publishing Group. http://ebm.bmj.com/. Accessed 1 July 2009
Kelly AM (2013) ACP Journal Club Web site. American College of Physicians. http://www.acpjc.org. Accessed 3 May 2010
Kelly AM (2014) ClinicalEvidence Web site. BMJ Publishing Group. http://clinicalevidence.bmj.com/ceweb/index.jsp. Accessed 3 May 2010
Kelly AM (1997) TRIP database. http://www.tripdatabase.com. Accessed 3 May 2010
Kelly AM (2014) ACP Smart Medicine. American College of Physicians. pier.acponline.org/index.html. Accessed 29 June 2014
Sadigh G, Parker R, Kelly AM et al (2012) How to write a critically appraised topic (CAT). Acad Radiol 19:872–888
Kelly AM, Cronin P (2011) How to perform a critically appraised topic: part 1, ask, search, and apply. AJR Am J Roentgenol 197:1039–1047
Kelly AM, Cronin P (2014) Levels of evidence (March 2009). Oxford Center for Evidence-Based Medicine. http://www.cebm.net/index.aspx?o=1025. Accessed 3 May 2010
Dodd JD (2007) Evidence-based practice in radiology: steps 3 and 4—appraise and apply diagnostic radiology literature. Radiology 242:342–354
Shea BJ, Hamel C, Wells GA et al (2009) AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. J Clin Epidemiol 62:1013–1020
Shea BJ, Hamel C, Wells GA et al (2014) The AGREE Collaboration. Appraisal of guidelines for research & evaluation (AGREE) instrument. www.agreecollaboration.org. Accessed 25 Feb 2011
Dans AL, Dans LF (2010) Appraising a tool for guideline appraisal (the AGREE II instrument). J Clin Epidemiol 63:1281–1282
Whiting P, Rutjes AW, Reitsma JB et al (2003) The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol 3:25
Maceneaney PM, Malone DE (2000) The meaning of diagnostic test results: a spreadsheet for swift data analysis. Clin Radiol 55:227–235
Cronin P (2009) Evidence-based radiology: step 3—critical appraisal of diagnostic literature. Semin Roentgenol 44:158–165
Fagan TJ (2014) Grade definitions. U.S. Preventive Services Task Force. http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm. Accessed 31 July 2014
Kelly AM, Cronin P (2011) How to perform a critically appraised topic: part 2, appraise, evaluate, generate, and recommend. AJR Am J Roentgenol 197:1048–1055
Kelly AM, Cronin P (2014) Agency for Healthcare Research and Quality clinical practice guidelines. U.S. Department of Health & Human Services. www.ahrq.gov/clinic/cpgsix.htm. Accessed 29 Sept 2014
Kelly AM, Cronin P (2014) Levels of evidence (March 2009). Oxford Centre for Evidence-Based Medicine. http://www.cebm.net/index.aspx?o=1025. Accessed 29 Aug 2014
Kelly AM, Cronin P (2014) ACR Appropriateness Criteria. American College of Radiology. www.acr.org/Quality-Safety/Appropriateness-Criteria. Accessed 17 July 2014
Kelly AM, Cronin P (2014) The Royal College of Radiologists Web site. www.rcr.ac.uk. Accessed 17 July 2014
Cronin P (2009) Evidence-based radiology: step 4—apply. Semin Roentgenol 44:180–181
Guyatt G, Jaeschke R, Heddle N et al (1995) Basic statistics for clinicians: 2. Interpreting study results: confidence intervals. CMA J 152:169–173
Akobeng AK (2007) Understanding diagnostic tests 2: likelihood ratios, pre- and post-test probabilities and their use in clinical practice. Acta Paediatr 96:487–491
Fagan TJ (1975) Letter: nomogram for Bayes theorem. N Engl J Med 293:257
Conflicts of interest
None
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
ESM I
(DOCX 25.7 kb)
Rights and permissions
About this article
Cite this article
Chughtai, A., Kelly, A.M. & Cronin, P. How to perform a critical appraisal of diagnostic tests: 7 steps. Pediatr Radiol 45, 793–803 (2015). https://doi.org/10.1007/s00247-014-3202-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-014-3202-y