The Value of Critically Appraised Literature
Utilization of critically appraised literature is the 3rd step in Evidence-Based Practice. Before evidence
can be integrated into clinical practice, the value of the evidence must be determined. Critically
appraised literature is important because of the vast quantity of information and the variability in the quality
of the information.
While there are various appraisal tools and worksheets available to appraise the
literature, the basic premise involves answering three general questions:
- Are the results of this study valid?
- Are the results of this valid study important?
- Are the results of this valid, important study applicable to my patient?
Critical appraisal can be an informal endeavor where a clinician evaluates the quality of one
study, or it can be more formal with the development of Critically Appraised Papers (CAPs) and
Critically Appraised Topics (CATs).
CAPs provide an appraised summary of one individual study,
whereas CATs are succinct manuscripts that attempt to answer a specific, focused clinical question
that ultimately provides a clinician friendly source of evidence to aid clinical decision making and
to identify areas of need for further research (McCluskey, 2004).
- Journal of Sport Rehabilitation
These manuscripts are a shorter summary of available evidence focused around a specific clinical question
in sport rehabilitation.
A critically appraised topic (CAT) is similar to a systematic review in that it
summarizes the best evidence in a body of literature; however, it is a shorter manuscript and less rigorous
critical review for answering the clinical question of interest. CATs provide an excellent mechanism for busy
evidence-based practice clinicians to collect and disseminate information they find while searching for answers
to important clinical questions. A CAT typically includes critically appraised literature of at least 3 high quality studies
but not more than 5.
Conversely, a summary of a single paper is referred to as a Critically Appraised Paper (CAP)
(NOTE: The JSR is NOT accepting CAPs for review). A CAT seeks to find the best available evidence in a less rigorous
search process, that is more readily available to clinicians, and then critically appraise the papers selected for
inclusion using accepted standards for evidence-based practice.
For an example CAT, please see
Valovich McLeod, TC. The effectiveness of balance training programs on reducing the
incidence of ankle sprains in adolescent athletes. J Sport Rehabil. 2008;17:316-323.
More information about CATs is available at www.otcats.com and