PT 741 Principles of Evidence Based Practice Format for creating CATS, (Critically Appraised Topic Sheets)

OUTLINE TO CRITICALLY APPRAISE A PROGNOSIS STUDY

Title of the CAT: A concise statement (similar to the clinical bottom line or clinical question) that will be used to catalogue the CAT. Clinical Bottom Line: Provide a concise summary of how the results can be applied, a description of how results will affect clinical decisions or actions. Clinical Scenario: Provide a concise description of the patient case. Include the patients age, gender, and information that is relevant to the clinical question. Clinical Question: This is the question that was developed from the patient case. It includes the elements of PICO: The patient/population, the intervention (in this case the diagnostic test) that is being considered, a comparison (if relevant), and the outcome of interest (in this case, prognosis). Search Terms: Describe the search strategy used to obtain the study or studies that are being appraised. Include the search engine and database that was used, and the terms that were entered to locate the articles. Indicate steps and numbers of useful references obtained at each step. Is the evidence about prognosis in this study valid? Provide explanations of Yes/No answers if appropriate. 1. Was the sample of patients representative of the population? 2. Were the patients sufficiently homogeneous with respect to prognostic risk? 3. Was follow-up sufficiently long and complete? 4. Were objective and unbiased (e.g. blinded) criteria used as outcomes? Is the evidence important? Summarize the results of the study that provide evidence for prognostic risk associated with the tested variables. Provide specific data as appropriate, including odds ratios, confidence intervals, or other estimates of survival or follow-up for each outcome variable. Put data in tabular form if appropriate. Is this evidence important for my patient? 1. Are the study patients similar to my own? 2. Will these results impact my conclusions about how to treat this patient, or what to tell the patient? Additional Comments: Provide any additional critical comments on the study, including issues related to the sampling, methods, data analysis, quality of discussion and interpretation of results. Citation: Provide the full citation for the article used in the CAT, using AMA format (see Physical Therapy journal for examples). Name of Appraiser Date of Appraisal

Critically Appraised Topic (CAT) for a Prognostic Study Title: Clinical Bottom Line: Clinical Scenario: Clinical Question: Search Terms: Summary of Study: Was a defined, representative sample of patients assembled at a common (usually early) point in the course of their disease? Was the patient follow-up sufficiently long and complete? Were objective outcome criteria applied in a blind fashion?

Yes Yes Yes

No No No

Cant tell Cant tell Cant tell

If subgroups with different prognoses are identified, was there Yes No Cant tell adjustment for important prognostic factors? Was there validation in an independent group (test set) of patients? Are the valid results of this prognosis study important? How? Can we apply this valid, important evidence about prognosis in caring for our patient? Other relevant information: The Evidence

Comments Citation Appraiser(s): Date of Appraisal:

Townsend,E. (2014,January). Evidence Based Practice for Physical Therapists [Course material]. MGH IHP PT 741.