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FLAOrthoPT -> CAT (September 18, 2005 12:37:00 PM)
does anyone here make CATs on a regular basis. If not or if so, would anhone like to start making a CAT database on here?

SJBird55 -> Re: CAT (September 19, 2005 2:03:00 AM)
Ben, what does CAT mean? I first think of those furry creatures that we can't have here because of our dogs' innate ability to eat them... and then think of something alternative therapy in nature. I'm pretty sure you aren't talking fuzzy mammals.

JLS_PT_OCS -> Re: CAT (September 19, 2005 8:17:00 AM)
Ben- Sounds like a fantastic idea. Perhaps those of us working on our DPTs could post ours to the site. I'm not sure how that works, perhaps David A. could comment on whether or not this is feasible? SJ- I have both types of CATs at home, my furry ones wouldn't go down a dog's throat too well, all any poor dog would be facing would be the business end of some claws. My kitty cats are small, but fierce. Know what I mean? :) Ben is referring to a type of evidence based Critical Appraisal of a Topic. It summarizes the most recent evidence about a given topic into a useful form that can be used to inform our practice. I am sure with starting a practice that you're too busy to begin a DPT, but seeing what others are doing can be a good start. I know that is the type of thing that worked for me. I saw the kinds of things other people were learning and using, and just got excited to do it myself. It sure is fun working full time AND going to school! Yay! :) J

Alex Brenner PT MPT OCS -> Re: CAT (September 19, 2005 9:34:00 AM)
Would it be a good idea for this website to move towards a BLOG format where moderators could post files etc.? Similar to the Evidence in Motion website.

SJBird55 -> Re: CAT (September 19, 2005 9:37:00 AM)
Jas, your cats are smart then. Something has happened in this area where cats have been dumbed down or something. They have a stupid habit of running versus standing their ground and using their claws. As soon as they run, they are dead meat. I wish our one particular dog would learn what cats canreally be like - then we'd be able to have a couple of them in the barn. Me not doing a DPT has nothing to do with starting a business or time... personally, I don't see the financial return. It all sounds fine and dandy and has some decent strengths, but I'd only do it if someone else decided to pay for me to do it. We just invested a nice chunk of change on me attempting this business thing... if my business plan is correct, well, I can see a return on this particular investment.

FLAOrthoPT -> Re: CAT (September 19, 2005 12:23:00 PM)
if you think the DPT is for financial reasons then you should never do it, even if someone pays for you. That is the last thing it could ever do, I am not going to go one about why one may want to get their DPT, we have beaten it to death on this forum, but mainly to make their practice patterns more efficient and up to date, it really comes into adopting and adapting to EBM and boning up on radiology and pharmacology. Then, it also will bring you on par with grads of today when you both are looking for a job be in in management or in a clinic or when marketing to a doc, and someone asks "why do they have a dpt and you do not." then second you need to answer that question, the DPT was worth it. I only see patients on a word of mouth cash paying basis. I also manage a PT staffing and home health firm, and ear well over 6 figures...you think I am doing the DPT for financial reasons? The DPT is way more than that, but it going to take you opening your mind about what it can do for you and more appropriately what it can do for the profession in the eyes of the other medical comunities and the public. And as much money you think you'll earn in private practice, since you mention financial gain, when was the last time you earned 5 million in one year? Go ask some chiros how being Doctors in the eyes of the public, some of the medical communtiy, and more importantly the public has done for them financially, it could bring our profession into an entire different financial position...ok I am done soap boxing. Anyway, I am in the DPT transition now, hence my learning of CATS, and hence i can share mine, etc..it would be kind of cool to post them on here...

SJBird55 -> Re: CAT (September 19, 2005 1:13:00 PM)
Ben, when I find it necessary to have a DPT to do my job adequately because of changing rules, laws, regulations, then, definitely, I'll jump on in and do it. I'll be out a job otherwise and it would be a financial risk NOT to have a DPT. Right now, the way I see the future and knowing historically the way laws are changed, I'll roll the die and gamble that I'll be just fine with the level of education I have and continuing to educate myself through other various avenues that are not at the high cost of a formal DPT. A DPT is never going to resolve the issues of our profession... we have no "image" of what it is we exactly do, we don't have direct access equally across the states, there isn't any proof whatsoever that a DPT provides more effective care, the licensure exam is the licensure exam no matter the level of education, heck, we don't even have a frickin definition of what "quality" even means or what needs to be met to ensure "quality." Do you really believe that the DPT is the only way to adapt EBM into practice? What does one do after getting a DPT that ensures the person is still right on up there and learning? My goal isn't to make 5 million... we all have different goals and sorry, I just don't believe the DPT is for me right now and it doesn't fit into the scheme of how I make decisions. And I'm also not one to play that "trump" card of sorts and say I'm a "doctor" of physical therapy. I don't need that whole kind of attitude of sorts or playing with words in the public eye... and right now, that's how I kind of view it. Sure, it'd be nice to have, I guess... but I don't value it to the degree that I'm going to go buy it.

FLAOrthoPT -> Re: CAT (September 19, 2005 2:28:00 PM)
living in a bubble and complaining about the weather inside does no good either. What about stop being one of the 75% of apathetic PTs who sit back and say what have you done for me lately and i see no gain in it for me, and get up and do something about it. Maybe the DPT will not help you, I still know it will not help me in any way, but it is a way of helping our profession as a whole. I cannot convince you of this, nor am I going to try. We don't have this we don't have that, it's got to start somewhere don't you think? I am not saying go get a DPT or you are a loser, but poking fun at something that will utlimately change your profession you belong to is not getting you anywhere either. It is fine to be in practice with blinders on, I am sure your patients love you, i am sure you get them better, i am sure you can make a living. Like I said I was not going to have this discussion with you or anyone for that matter, it is just that one day it'll click, the vision will make sense, and you'll see why it makes sense to bring the level of standards up a notch or three. Fortunately or unfortunatley I have seen our profession from many varied angles, as a clinician in a clinic, as a director, clinic owner, and in administration, and on boards...you'd be surprised what we are thought of as a whole and sitting back and perpetuating it does no good either. So one day, maybe you'll grasp the true reason for getting a DPT, until then, keep treating, be happy, be productive. I am not picking on you, just that you represent way too many of the PTs out there so it is my way of trying to make a change one PT at a time. But if the DPT passes you by I am sure you in your paradigm of life and profession will not see on ill effect, so no sweat...me on the other hand I cannot stand to see any other profession gobble up our turf or any insurance company reducing what we do to underskilled or different professions all together. Ok, got to go see the red sox win, take care ben

David Adamczyk -> Re: CAT (September 20, 2005 5:28:00 AM)
Hello, We would be happy to support any effort that increases the awareness and use of evidence in practice. Let's use this thread to brainstorm the idea of bringing CATS to RehabEdge. As ideas are generated and refined, we will look into how we can make them work on the site. I think that the power of this Forum is that we can study the CATs together and discuss in depth how they should AND do impact our practice. Thanks for your input. :) Dave

FLAOrthoPT -> Re: CAT (September 20, 2005 11:37:00 AM)
well I have a CAT maker program that I would need to see how we can get it authorized for widespread use, but maybe having that program available so people can make their cats on here, then divide them based on subject matter and date of submission, etc...have a place where people can comment, etc...I think it is pretty feasible, one of my projects in my DPT program is the feasibility of CATS as opposed to the benefit of CATS. We all know CATs are great in theory but are they able to be done in a manner that they can be recalled and stored, etc..that is the big question, i do not think anyone has figured it out, and i'd say if we do it here, you'll be slightly famous. The software comes witht he purchaes of EBM how to practice and how to teach by straus richardson glasziou and haynes, Third edition. Like I said, as this class goes on i think i'll have a bit more insight, but any ideas regarding how to incorporate EBM in the form of CATs and not be blind sided enough to think that our every day practice patterns are the way we should practice regardless of the new studies being done, would be appreciated. I'll chat soon- Ben

David Adamczyk -> Re: CAT (September 26, 2005 4:57:00 PM)
Ben, Are PT students the primary producers of CATs? Dave

Jon Newman -> Re: CAT (September 26, 2005 5:03:00 PM)
You can download CAT maker tools for free. Just google "CATmaker downloads" and you'll have a selection. jon

FLAOrthoPT -> Re: CAT (September 27, 2005 4:50:00 AM)
I would guess that yes, only because the true wave of EBM is starting in school. They were started at a university, but they are WAY more common in other fields, medicine, nursing, etc. But since EBM is now just making more of a stand in PT, then most CATs are being produced at the university level, or big teaching hospitals, etc. They are not well known, I'd wager less than 2% of people on here even know about them.

David Adamczyk -> Re: CAT (September 27, 2005 3:54:00 PM)
When I was in school, we did several literature reviews and I imagine that students are still writing them now. Do you think that there is value in compiling these and discussing them on the site? If so, perhaps this would be a more feasible way to start the project. Your thoughts?

FLAOrthoPT -> Re: CAT (September 27, 2005 7:37:00 PM)
lit reviews are VERY helpful, CAT is just one way to organize a lit review, and a standard form for easier quick glance at a lit review, kind of takes the basics out of a lit review. But, yes, sure, lit review would be nice, maybe break it into categories of orthopedic, outcomes, etc...I think there are a lot of us reading journals, but maybe if we could some up some key points it'd be nice.

JLS_PT_OCS -> Re: CAT (October 11, 2005 11:21:00 AM)
http://www.evidenceinmotion.com/cats.aspx Perhaps a link here would be worthwhile instead... J

Dr.Wagner -> Re: CAT (October 16, 2005 6:47:00 AM)
We used CATs in residency...and usually it was a pretty volatile discussion. It takes alot of time to do it correctly. So I am pretty experienced with them. I personally don't think the "CAT maker" programs are terribly helpful, they tend to be a bit overbearing. Quite honestly, CATs can be difficult. But are extremely important, the more you do, the more you realized most journal articles are TERRIBLE and really don't prove their points well.

srcase -> Re: CAT (October 16, 2005 4:40:00 PM)
In PT school, I did a literature review on the prevalence of LBP in adolescents. It covered over 40 articles. In the end, I decided to do a criterion-based methodological critique of 30 of the articles, and only two articles scored above 80% in terms of reliability, validity and generalizability of results. It was a heck of a lot of work to organize, but overall, gave a much clearer picture of what the literature showed. Is that what a CAT does?? If so, I would have loved to have used it for my literature review back then. Sarah

FLAOrthoPT -> Re: CAT (October 17, 2005 8:05:00 PM)
pretty much yes...

Dr.Wagner -> Re: CAT (October 18, 2005 7:49:00 AM)
If anyone would be interested, I have probably 10 CATs saved, I could email an example. Just PM me. You take an article (generally from a well respected journal, say NEJM), you go over it with a fine tooth comb. You anylize their statistics determine "are the results valid", review the TYPE of study, was it the best for the subject? Was their statistical significance, was there clinical stignificance, are the results applicable to my practice, what is the magnitude of risk, is there follow up etc.

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