Critical Appraised Topics (CATs) – what are they and how do you create one?

A Critically Appraised Topic (CAT) is a form of summarised evidence that tries to present an answer to a specified clinical question. A CAT is different to a systematic review or meta-analysis as the intention is not to systematically seek out all the evidence on a topic, but to look for the best available evidence and quickly come up with an answer. A CAT might be appropriate where there was no national guidance, but is not robust on its own to override existing national guidance.

A CAT starts with a well-defined clinical question that is relevant, well-structured and answerable. This then needs to be translated into a search question using a framework such as PICO (Patient or problem, Intervention or exposure, Comparison or control, Outcome(s)).

For a therapy questions, PICO would consist of the patient's disease or condition, a therapeutic intervention (for example a drug, surgical intervention, or medical advice). The comparison might be standard care, another intervention, or a placebo, and the outcome might be, for example, reduced mortality rate, complications, or disease recurrence.

The P (Patient or problem) may also include information about the population group (for example, older people, or women).

For example, the question ‘In a patient with acute bronchitis, do antibiotics reduce sputum production?’ could be put into a PICO framework as:

  • P patients with acute bronchitis
  • I antibiotics
  • C none (it’s not always necessary to have a comparison)
  • O reduction in sputum production

The PICO framework aids searching in databases, by allowing you to search for each concept separately using thesaurus and free-text terms to cover synonyms and variant spellings, and then combine the searches together to find research that covers all the concepts.

Since most CATs are related to therapy questions, the most appropriate study design would be an existing systematic review, or randomised controlled trials (RCTs) and these could be found in databases such as the Cochrane Library, Medline, EMBASE and CINAHL. Search filters are available to help limit the search to systematic reviews or RCTs.

Library staff are happy to either provide training and assistance on how to search these databases, or can carry out evidence searches on your behalf.

Once suitable articles have been found, they need to be appraised for their validity, and the CASP checklists are a good way to do this. There are different checklists available different types of evidence, and each one asks the most pertinent questions for that type of research.

The final stage is to summarise the evidence to come up with an answer to the clinical question initially posed, or a clinical ‘bottom line’.

Library staff are happy to support the development of CATs through suggesting suitable search terms or translating a clinical question into PICO, selecting databases, and providing critical appraisal resources, and we can point you in the direction of further resources.

Resources on Strep A from UpToDate

The UpToDate point of care tool has a range of regularly updated articles summarising the evidence around Strep A.

These are being made available to anyone that needs access, without having to login to UpToDate.

All staff at Shrewsbury and Telford Hospital NHS Trust have access to UpToDate, both on and off-site of via the mobile app.

Quick links to Strep A information

As with all UpToDate clinical content the topics are written by experts in their field and the content is reviewed and updated as new evidence becomes available to support clinicians in reaching a diagnosis and treating patients who present with suspected Strep A quickly and effectively.

Learn how to search the evidence with our database training sessions

If you're looking to learn how to find published evidence in healthcare journals, we're running a series of training sessions over the next few months.

These cover the CINAHL, Medline and EMBASE databases and will help you to search effectively and access the full-text of articles. Some sessions are face-to-face, while others will take place over Microsoft Teams. These databases offer you the ability to do advanced searching using thesaurus teams as well as free-text searching - for more basic searches you could try the NHS Knowledge and Library Hub.

Searching the literature using CINAHL and Medline via EBSCO

Learn how to effectively search the healthcare journal literature using CINAHL and Medline via the EBSCO interface. The training is open to all staff, but is mainly aimed at nurses, midwives and allied health staff.

  • 22nd Feb 2-3.30, IT Training Room, Shrewsbury Health Library, RSH
  • 20th Apr 2-3.30, Microsoft Teams
  • 24rd May 10-11.30, IT Training Room, Shrewsbury Health Library, RSH

Searching the literature using Medline and EMBASE via Ovid

Learn how to effectively search the healthcare journal literature using Medline and EMBASE via the Ovid interface. The training  is open to all staff, but is mainly aimed at doctors.

  • 3rd Feb 10-11.30, Microsoft Teams
  • 15th Mar 10-11.30, IT Training Room, Shrewsbury Health Library, RSH
  • 4th May 9-10.30, Microsoft Teams
  • 15th Jun 2-3.30, IT Training Room, Shrewsbury Health Library, RSH

To book a place, visit the SaTH Learning Made Simple website (search for 'library) or contact Jason Curtis in the Shrewsbury Health Library on 01743 492511 or

You'll need a free NHS OpenAthens account to access the databases.

Can't make any of these sessions? We can still offer one-to-one training sessions in person or over Microsoft Teams - contact us for more details.

BMJ Best Practice Comorbidities Manager

Access to BMJ Best Practice has been extended to include the Comorbidities Manager. In the UK, one in three adults suffer from multiple chronic conditions and most patients in the acute setting have more than one medical condition.

The BMJ Best Practice Comorbidities Manager supports the management of the whole patient by including guidance on the treatment of a patient’s acute condition alongside their pre-existing comorbidities.

Available on desktop or app, NHS staff and learners in England can use BMJ Best Practice for free via an NHS OpenAthens account.

Improve your wellbeing and resilience with a new collection of e-books

A new collection of 21 carefully selected e-books has been made available to support the wellbeing and resilience of NHS staff and students. These are all available to read online with a free NHS OpenAthens account.

In addition to these new e-books, you'll find many books to support your wellbeing in our Healthy Lives collections in both our libraries, so do come along a have a browse. We also have jigsaws, colouring books, comfortable seating, and hot drinks, so come along and take some time to look after yourself.

And Breathe
Dennis, S. 2016

Drayton M. 2021

Change for the Better: Personal Development through Practical Psychotherapy
McCormick, E. W. 2017

Developing Mental Toughness
Clough, P., Strycharczyk, D. and Perry, J. 3rd ed., 2021

Developing Resilience
Neenan, M. 2nd ed., 2017

Emotional Resilience
Bharwaney, G. 2015

GP Wellbeing
Staten, A. and Lawson, E. 2017

Managing Health and Wellbeing in the Public Sector
Cooper, C. L. and Hesketh, I. 2017

St. John, B. and Haines, A. P. 2017

Mindfulness in the Workplace
Chapman-Clarke, M. A. 2016

Organised Wellbeing
Marsh, T. and Ward, L. 2nd ed., 2018

Resilience at Work
Jackson, K. 2018

Resilience in Healthcare Leadership
Belasen, A. 2021

Self-care for Allied Health Professionals
Battye, A. 2021

Self-leadership and Personal Resilience in Health and Social Care
Holroyd, J. 2015

Seven Ways to Build Resilience
Johnstone, C. 2021

Stories of Resilience in Nursing
Traynor, M. 2019

Supporting Compassionate Healthcare Practice
Ryder, E. and Chambers, C. 2018

The Compassionate Mind Approach to Difficult Emotions: Using Compassion Focused Therapy
Irons, C. 2019

The Leader's Guide to Resilience
Tang, A. 2020

Your Health at Work
Fidderman, H. and Allen, B. 2018

Learn how to use UpToDate to answer your clinical questions

UpToDate is a point of care tool for answering clinical questions, and is available to all staff and students at Shrewsbury and Telford Hospital NHS Trust on-site, off-site and via the mobile app.

Over 100 independent studies confirm that UpToDate provides healthcare professionals with evidence-based clinical decision support that improves outcomes and service delivery.

Two free 60-minute webinars are taking place in August to help you make the most of the UpToDate system, and will cover:

  • Creating an account
  • Earning and redeeming CPD points
  • How to search for answers to your clinical questions
  • Customising your UpToDate homepage
  • Reducing medication errors with the Drug Interactions tool
  • COVID-19 common questions and answers
  • What's New & Practice Changing Updates
  • Patient engagement/safety

To register for either webinar, simply follow the links below.


Making finding full-text easier

Whether you've got the title of an article you're looking for, want to look at the latest issue of a journal, or want to be able to access full-text articles when searching the web, there are a number of ways library and knowledge services can help.

From searching within the NHS Knowledge and Library Hub, using BrowZine, using LibKey Nomad, or using Google Scholar Library Links, our short guide and video show you how to make finding full-text a bit easier.

And if there is no full-text available, it's easy to request items from the library and let us do the leg-work!

Watch the video

Make better use of evidence and knowledge with 'The Knowledge' newsletter

Want to know how to make better use of evidence and organisational knowledge in your work? Have a look at our latest newsletter called 'The Knowledge' that looks at knowledge mobilisation.

Download the latest issue of 'The Knowledge'

The latest issue covers:

  • Using Trip Pro to locate evidence
  • Sharing knowledge with knowledge cafés and expresso cafés
  • Share your publications in the Staff Publications Hub
  • Advanced searching for articles
  • Learn how to use knowledge resources quickly with our bite-sized training videos


Celebrate World Book Night 2022 with a free book

Celebrate World Book Night 2022 with Shrewsbury and Telford Health Libraries, and collect your FREE book gift bag from Shrewsbury or Telford Health Library on Friday 29th April 2022 between 8.30 and 17.00 - while stocks last.

De-stress with a good book.  Get lost in a good murder with a free copy of 'The Dinner Guest' by B P Walter. The tragic end to an intimate dinner in an affluent West London home unearths a mesh of secrets and deception in this chilling, ingeniously plotted domestic noir.

On a similar theme, why not try your hand at our Murder Mystery Puzzle competition? You could win a book token!

World Book Night is a national celebration of reading and books which takes place in April every year.  Books are given out across the UK to enable people to re-discover the pleasure of reading.  World Book Night is run by The Reading Agency, a charity that inspires people to become confident and enthusiastic readers.

What are the benefits of reading for pleasure?

  • 19% of readers say that reading stops them from feeling lonely
  • Higher literacy skills are associated with a range of positive societal benefits, including having a stronger sense of belonging to society and being more likely to trust others.
  • Studies have found that reading for pleasure enhances empathy, understanding of the self, and the ability to understand one’s own and others’ identities
  • Regular readers for pleasure reported fewer feelings of stress and depression than non-readers, and stronger feelings of relaxation from reading than from watching television or engaging with technology intensive activities
  • Those who read for pleasure have higher levels of self-esteem and a greater ability to cope with difficult situations. Reading for pleasure is associated with better sleeping patterns
  • Adults who read for just 30 minutes a week are 20% more likely to report greater life satisfaction
  • A study of 1,136 self-reported ‘avid-readers’, indicates that shared reading experiences and recommendations supporting choice are key influences on positive attitudes towards reading

Health Services Transformation Bulletin now available

We've just published the second issue of our new Health Services Transformation Bulletin.

This new bulletin supports the recovery of health services and their future development, covering topics such as digital medicine, organisational development, patient flow, virtual wards, and workforce issues.

Containing research, articles, reports and case studies, the bulletin will provide the evidence to support change and innovation.

Many of the evidence resources listed in the bulletin can be accessed without any passwords, but some will need an NHS OpenAthens account, or require free registration. Where the item cannot easily be accessed, we've provided link to request a copy from the library.