Critically Appraised Topics (CATs) in Veterinary Medicine: Applying Evidence in Clinical Practice

Arlt, Sebastian; Belshaw, Zoe; Buckley, Louise; Corah, Louise; Doit, Hannah; Fajt, Virginia R.; Grindlay, D. J. C.; Moberly, Heather K.; Morrow, Lisa; Stavisky, Jenny; White, Constance

doi:10.3389/fvets.2020.00314

Cited by 22 publications

(19 citation statements)

References 52 publications

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“…Many authors claim that practitioners should be aware of the latest research findings in order to choose the best examination and treatment options of their patients. 1 According to the evidence-based veterinary medicine (EBVM) manifesto launched by Vet Record, it is necessary to bring the best available evidence into the consultation room so that particular problems can be better handled by the veterinarian and that clients are better informed about the options they are given. 2 The latest scientific information is usually brought to the veterinarian via scientific journals.…”

Section: Introductionmentioning

confidence: 99%

Study design quality of research on dogs published in peer‐reviewed journals

Schulte

Arlt

2022

Veterinary Record

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Background: In the past it has been criticised that only a low proportion of well-designed and well-reported studies in some medical specialities is available. The objective of this study was to systematically evaluate the quality of literature about canine medicine published in peer-reviewed journals in relation to six specific veterinary medicine specialities. Methods: A literature search was conducted and 25 studies per speciality were selected. The quality of the articles (n = 150) published between 2007 and 2019 was evaluated with a validated checklist. Results: In articles related to all specialities, deficits were found, such as not adequate number of animals in 60.0% of the studies. In 88.0%, information about housing and feeding of the dogs were not specified. In 69.4% of the prospective clinical studies, an ethical approval was reported, and written informed consent of the owners was obtained in 46.2%. Conclusions:The findings revealed extensive deficits in the design and reporting of studies in canine medicine. The demand for improvement is obvious and should be addressed by authors, reviewers and journal editors in the future. Our results underline that practitioners should critically appraise the quality of literature before implementing information into practice.

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Section: Introductionmentioning

confidence: 99%

Study design quality of research on dogs published in peer‐reviewed journals

Schulte

Arlt

2022

Veterinary Record

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“…These included the following: CAB Abstracts and Global Health (1973-present), the National Library of Medicine (PubMed), ScienceDirect, and the WHO Institutional Repository of Information Sharing (IRIS) [22] and "Echinococcosis" webpage [11]. PubMed and CAB abstracts produce comprehensive veterinary and human medical research [23][24][25], while the ScienceDirect database produces full text, peer reviewed literature on healthcare [26]. Additionally, the WHO resources were searched, as it is one of the leading international organizations conducting CE programs in endemic regions.…”

Section: Methodsmentioning

confidence: 99%

Cystic Echinococcosis: An Impact Assessment of Prevention Programs in Endemic Developing Countries in Africa, Central Asia, and South America

Christofi

2022

Journal of Zoological Systematics and Evolutionary Research

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Background. Cystic echinococcosis (CE), caused by the tapeworm species, Echinococcus granulosus sensu stricto (G1), is one of many primary neglected zoonoses worldwide. Within endemic developing countries, CE has multiple effects on animal and human health and well-being. To address such effects, veterinary and human medical sector collaboration on prevention program delivery is essential. To begin preliminary evaluations of county specific prevention programs, a critically appraised topic (CAT) was conducted. It sought to answer: What impact do CE prevention programs have on human and animal disease prevalence, in populations living in endemic developing countries within Africa, Central Asia, and South America? Methodology. The aim was to assess the ability of prevention and control program outputs to produce measurable differences in health, social, and economic outcomes (e.g., improved access to medical services, positive behavioral change, or reduced treatment costs, respectively). Included articles were obtained using predefined inclusion/exclusion criteria from the four databases (CAB Abstracts and Global Health; the National Library of Medicine (PubMed); ScienceDirect; and WHO Institutional Repository of Information Sharing (IRIS)). The articles were appraised using three checklists: the Royal College of Veterinary Surgeons (RCVS), the Critical Appraisals Skills Programme (CASP), and the Joanna Briggs Institute checklists. Results. Ten articles were selected. Geographically, 20% of studies were conducted in South America, 30% in Africa, and 50% in Central Asia. For definitive hosts, dogs, CoproELISA antigen testing, before and after Praziquantel (PZQ) de-worming, was a primary focus. For humans, who are intermediate hosts (IH), disease surveillance methods, namely ultrasound (US), were commonly assessed. Whilst for sheep, also acting as IH, disease prevention methods, such as the EG95 livestock vaccine and de-worming farm dogs, were evaluated. Common to all studies were issues of program sustainability, in terms of regular human US screening, dog de-worming, and annual sheep vaccination. This was attributed to transient and remote human or animal populations; limited access to adequate roads or hospitals; few skilled health workers or veterinarians; an over-reliance on communities to administer preventatives; and limited resources. Conclusion. Despite variations in result validity and collection periods, useful comparisons of CE endemic countries produced key research and program recommendations. Future research recommendations included testing the significance of multiple program outcomes in relation to prevalence (e.g., the social outcome: behavioral change), further research on the impact of livestock vaccinations, and the CE transmission role of waterways and sanitation. Program recommendations included calculating and distinguishing between stray versus owned dog populations; formal representation of internal and external stakeholder interests through institutional organization; establishing sustainable guidelines around the frequency of PZQ and vaccination administration; improved veterinary-human medical training and resource sharing; and combined prevention methods and multiple canine disease management.

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“…Formal methods have been developed to systematically identify, select, and synthesize the available evidence to assist veterinary professionals in evidence-based decision-making. These include critically appraised topics (CATs) ( 4 ), systematic review and meta-analysis (SR-MA) ( 5 – 7 ), and clinical practice guidelines ( 8 ) (see Box 1 for a short overview of these methods). These evidence synthesis approaches have different purposes which results in different processes and endpoints, but each includes an assessment of the internal validity of the research used.…”

Section: Introductionmentioning

confidence: 99%

“…Critically appraised topics: Critically appraised topics (CATs) use the same principles as systematic reviews to address clinical questions but employ a more rapid approach, particularly in relation to the screening and summation of the evidence. They were designed to be employed by clinicians as a way of rapidly gathering and interpreting evidence on clinical questions relating to specific cases ( 4 ). Therefore, there is a greater risk that research addressing the question may be missed.…”

Section: Introductionmentioning

confidence: 99%

Levels of Evidence, Quality Assessment, and Risk of Bias: Evaluating the Internal Validity of Primary Research

Sargeant

O’Connor

2022

Front. Vet. Sci.

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Clinical decisions in human and veterinary medicine should be based on the best available evidence. The results of primary research are an important component of that evidence base. Regardless of whether assessing studies for clinical case management, developing clinical practice guidelines, or performing systematic reviews, evidence from primary research should be evaluated for internal validity i.e., whether the results are free from bias (reflect the truth). Three broad approaches to evaluating internal validity are available: evaluating the potential for bias in a body of literature based on the study designs employed (levels of evidence), evaluating whether key study design features associated with the potential for bias were employed (quality assessment), and applying a judgement as to whether design elements of a study were likely to result in biased results given the specific context of the study (risk of bias assessment). The level of evidence framework for assessing internal validity assumes that internal validity can be determined based on the study design alone, and thus makes the strongest assumptions. Risk of bias assessments involve an evaluation of the potential for bias in the context of a specific study, and thus involve the least assumptions about internal validity. Quality assessment sits somewhere between the assumptions of these two. Because risk of bias assessment involves the least assumptions, this approach should be used to assess internal validity where possible. However, risk of bias instruments are not available for all study designs, some clinical questions may be addressed using multiple study designs, and some instruments that include an evaluation of internal validity also include additional components (e.g., evaluation of comprehensiveness of reporting, assessments of feasibility or an evaluation of external validity). Therefore, it may be necessary to embed questions related to risk of bias within existing quality assessment instruments. In this article, we overview the approaches to evaluating internal validity, highlight the current complexities, and propose ideas for approaching assessments of internal validity.

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Critically Appraised Topics (CATs) in Veterinary Medicine: Applying Evidence in Clinical Practice

Cited by 22 publications

References 52 publications

Study design quality of research on dogs published in peer‐reviewed journals

Study design quality of research on dogs published in peer‐reviewed journals

Cystic Echinococcosis: An Impact Assessment of Prevention Programs in Endemic Developing Countries in Africa, Central Asia, and South America

Levels of Evidence, Quality Assessment, and Risk of Bias: Evaluating the Internal Validity of Primary Research

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