Epidemiological research and evidence based medicine: How do they fit and for whom

Slater, Margaret R.

doi:10.1016/j.prevetmed.2010.09.013

Cited by 5 publications

(3 citation statements)

References 39 publications

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“…Conversely, there were eight confounded findings that would have been accepted as significant if only univariable analysis had been applied but that did not show associations after accounting for confounding in multivariable analysis: periodontal disease, obesity, overgrown nail(s), retained deciduous tooth, lameness, skin mass, osteoarthritis and lipoma. Reporting false positive and false negative results in scientific studies carries increasingly detrimental risks for dog welfare as we move into the era of evidence based veterinary medicine and policy 70 , 71 . Results from canine health studies influence breed club health initiatives, research funding, animal charity campaigning and government policy 36 , 73 – 75 and thus the reliability of research findings are critical if we are to optimise decision-making on future dog welfare strategies.…”

Section: Discussionmentioning

confidence: 99%

Unravelling the health status of brachycephalic dogs in the UK using multivariable analysis

O’Neill

Pegram

Crocker

et al. 2020

Sci Rep

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Brachycephalic dog breeds are regularly asserted as being less healthy than non-brachycephalic breeds. Using primary-care veterinary clinical data, this study aimed to identify predispositions and protections in brachycephalic dogs and explore differing inferences between univariable and multivariable results. All disorders during 2016 were extracted from a random sample of 22,333 dogs within the VetCompass Programme from a sampling frame of 955,554 dogs under UK veterinary care in 2016. Univariable and multivariable binary logistic regression modelling explored brachycephaly as a risk factor for each of a series of common disorders. Brachycephalic dogs were younger, lighter and less likely to be neutered than mesocephalic, dolichocephalic and crossbred dogs. Brachycephalic differed to non-brachycephalic types in their odds for 10/30 (33.33%) common disorders. Of these, brachycephalic types were predisposed for eight disorders and were protected for two disorders. Univariable and multivariable analyses generated differing inference for 11/30 (30.67%) disorders. This study provides strong evidence that brachycephalic breeds are generally less healthy than their non-brachycephalic counterparts. Results from studies that report only univariable methods should be treated with extreme caution due to potential confounding effects that have not been accounted for during univariable study design or analysis.

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Section: Discussionmentioning

confidence: 99%

Unravelling the health status of brachycephalic dogs in the UK using multivariable analysis

O’Neill

Pegram

Crocker

et al. 2020

Sci Rep

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“…No attempt was made in the current study to apply retrospective diagnostic criteria to confirm or exclude cases diagnosed as hypothyroid by the attending veterinary surgeon because we aimed to report on primary care veterinary caseloads as they are recognised and diagnosed rather than to cleanse these caseloads retrospectively based on external superimposed diagnostic criteria. It is also recognised that the attending veterinary teams would have access to, and considered, many additional diagnostic aids such as their personal history with the animal and the owner, the full presenting phenotype and their personal clinical experience that would be challenging to assess via the clinical records alone but that are recognised as being critical components of the evidence-based triad for diagnosis [ 33 , 51 ]. Although this may have allowed inclusion of some misclassified cases, this big data study of a primary-care caseload aimed to reflect diagnostic protocols used in primary-care practice and to provide results with generalisability to the wider dog population.…”

Section: Discussionmentioning

confidence: 99%

Frequency, breed predispositions and other demographic risk factors for diagnosis of hypothyroidism in dogs under primary veterinary care in the UK

et al. 2022

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Background Hypothyroidism is a commonly diagnosed endocrinopathy in dogs. This study aimed to investigate the frequency and risk factors for diagnosis of hypothyroidism in UK primary-care practice. Dogs diagnosed with hypothyroidism were identified by searching electronic patient records of primary-care practices participating in VetCompass. A cohort study design estimated one-year (2016) period prevalence and incidence risk for hypothyroidism. Multivariable binary logistic regression models were used to evaluate associations between demographic risk factors and hypothyroidism. Results From 905,553 dogs, 2,105 dogs were recorded with diagnosed hypothyroidism in 2016; 359 incident and 1,746 pre-existing, giving an annual prevalence of 0.23% (95% CI 0.22–0.24) and annual incidence risk of 0.04% (95% CI 0.04–0.04). Multivariable logistic regression identified 24 predisposed and nine protected breeds. Standard Doberman pinscher (odds ratio [OR] = 17.02, 95% CI 12.8–22.64), Tibetan terrier (11.25, 95% CI 8.27–15.32) and boxer (10.44, 95% CI 8.66–12.58) breeds showed high predisposition. Pug (OR 0.29, 95% CI 0.09–0.89), Yorkshire terrier (OR 0.38, 95% CI 0.24–0.59), Shih-tzu (OR 0.38, 95% CI 0.23–0.64) and Jack Russell terrier (OR 0.40, 95% CI 0.29–0.54) were the most protected breeds. Overall, being a purebred dog, being insured, having bodyweight above the breed-sex mean, increasing age, being neutered and rising adult bodyweight also showed increased odds being a dog living with a diagnosis of hypothyroidism. Conclusions Several strong breed predispositions for diagnosis of hypothyroidism were identified that can assist with disorder prioritisation in ongoing efforts to improve breed health. Other risk factors were also identified that can assist veterinary surgeons during clinical work-up of suspected cases. Identification of novel evidence for protected breeds provides useful information for research into genetic mechanisms.

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“…Nevertheless, these findings may become problematic when participation within communities is expected to be beneficial for professionals who have to base their actions not only on individual experience but also on evidence-based knowledge. In veterinary medicine, as in health care in general, evidence-based practice has become increasingly important (Goldenberg 2006;Slater 2010). When professionals want to make their practice evidence-based, communities will not help when they spend most of their time storytelling, instead of participating in critically reflective dialogues in which professionals explore reasons together and construct meaning collaboratively.…”

Section: Discussionmentioning

confidence: 99%

Critically reflective dialogues in learning communities of professionals

Groot

Endedijk

Jaarsma

et al. 2013

Studies in Continuing Education

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Communities in which professionals share and create knowledge potentially support their continued learning. To realise this potential more fully, members are required to reflect critically. For learning at work such behaviour has been described as critically reflective work behaviour, consisting of six aspects: challenging groupthink, critical opinion sharing, an openness about mistakes, asking for and giving feedback, experimentation and research utilisation. We studied whether and how these aspects can be distinguished in dialogues of seven different communities of veterinary professionals (critically reflective dialogues). Our exploration of the nature of critically reflective dialogues resulted in an analytical framework. Within each aspect four different modes of communication were identified: interactive, on an individual basis, non-reflective and restricted. We assume that professionals use learning opportunities most in the interactive mode of communication. The framework was employed to study the extent to which dialogues showed these modes of critically reflective dialogues. The results demonstrate that in these communities the modes of communication within aspects were largely non-interactive (i.e., individual, non-reflective). The developed framework discriminates between communities in terms of their critically reflective dialogues. Interventions to improve the effectiveness of learning communities should focus on enhancement of members addressing each other's reasons and reflections.

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Epidemiological research and evidence based medicine: How do they fit and for whom

Cited by 5 publications

References 39 publications

Unravelling the health status of brachycephalic dogs in the UK using multivariable analysis

Unravelling the health status of brachycephalic dogs in the UK using multivariable analysis

Frequency, breed predispositions and other demographic risk factors for diagnosis of hypothyroidism in dogs under primary veterinary care in the UK

Critically reflective dialogues in learning communities of professionals

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