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:

  1. Are the results of this study valid?
  2. Are the results of this valid study important?
  3. 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).

Additional Resources

  • 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 www.cebm.net.



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