International Evidence-Based Medicine Survey of the Veterinary Profession: Information Sources Used by Veterinarians

Cross-sectional survey of sources of information accompanying veterinary product advertisements in two professional print publications

BACKGROUND

Veterinarians should be able to easily access scientific evidence about medical products and devices to incorporate into their clinical decision making. While the characteristics and quality of supporting information accompanying device and pharmaceutical advertisements have been studied in human medicine, little is known about this topic in veterinary medicine. The aim of this study was to characterise the supporting information provided by manufacturers of prescribed products, tests or devices in promotional material found in two commonly read UK-based veterinary publications.

METHODS

Advertisements contained in issues of two veterinary periodicals published between July 2017 and July 2018 were analysed for advertisement and product characteristics and for items of accompanying information. Literature searches were conducted to assess the availability of peer-reviewed sources of information on advertised products.

RESULTS

A minority (16%) of the 451 analysed advertisements were accompanied by references to peer-reviewed literature, despite the availability of scientific literature for many of the products advertised.

LIMITATION

This study sampled two professional publications over a narrow time period.

CONCLUSIONS

There may be insufficient evidence being provided to veterinary professionals via marketing features; this may limit the accessibility of scientific information for clinical decision making around advertised products.

A global survey of companion animal veterinary practitioners on animal welfare teaching - Focus on undergraduate and continuing education, and clients' sources of information

As part of a wider research on animal welfare, a global survey was developed to gain insight into the opinion of companion animal veterinarians about animal welfare education, namely to investigate i) their exposure to animal welfare teaching during their undergraduate education, ii) their access to continuing professional education on animal welfare, and iii) their opinions on clients' sources of information on animal welfare. The survey was distributed to companion animal veterinarians around the world. The results were highly influenced by the large numbers of respondents who trained in the Russian Federation, Australia, Israel, the Netherlands, the United Kingdom of Great Britain and Northern Ireland, or the United States of America. Worldwide, 58.4% of the respondents thought that animal welfare was poorly covered or not taught at all when they were students. The best coverage of animal welfare was in the Netherlands and the United Kingdom of Great Britain and Northern Ireland. Most companion animal veterinarians (65.3%) had access to continuing education on animal welfare, but there were small differences between the six above-mentioned countries. Companion animal veterinarians get information on animal welfare mainly from the internet and veterinary conferences/meetings, and thought that their clients obtained animal welfare information from various sources. The findings show that there is a need to improve education on animal welfare in veterinary curricula and the provision of relevant continuing education, so that companion animal practitioners can keep abreast of developments and societal expectations.

A Global Survey of the Views of Practicing Companion Animal Veterinarians on Their Undergraduate Curriculum and Their Access to Continuing Education Resources

A global survey was developed to gain insight into the opinion of companion animal veterinarians about their undergraduate education and their access to continuing education on the following topics: client communication, animal welfare, surgical techniques, human-animal bond, dentistry, animal behavior, and zoonotic disease/epidemiology. In 2016, the survey was distributed via SurveyMonkey® in five languages to companion animal veterinarians around the world. A total of 1,167 respondents returned to the survey. The distribution of survey responses differed by geographic region (number of respondents in parentheses; where respondents work/have been trained): Europa (including the Russian Federation, 359/423), Asia (311/205), North America (77/89), South America (24/16), Africa (46/41), and Oceania (147/167). The results were strongly influenced by a large number of respondents (in parentheses) who graduated in the Russian Federation (180/162), Australia (133/154), Israel (136/82), the Netherlands (64/64), the United Kingdom of Great Britain and Northern Ireland (36/46), and the United States of America (46/44). On the basis of the responses, all topics were poorly covered or not taught, except for surgical techniques and zoonotic disease/epidemiology, which were covered adequately or well. However, there were country and geographic regional differences. This was also true for continuing education resources, which were-in addition to countries and geographic regions-also influenced by the educational topic. As already stated by Dhein and Menon in 2003, time away from the practice, travel distance, and expense may be reasons why companion animal veterinarians do not follow continuing education. Online continuing education could fill in the gap and is more time and cost-efficient.

Most veterinarians treating exotic animals use formularies to select drug dosages without consistently checking their sources

OBJECTIVE

To assess what information sources veterinarians use to select drug dosages for treating exotic animals and how they implement this information.

SAMPLE

936 veterinarians from Europe, Asia, Australia, Africa, and the Americas.

PROCEDURES

An anonymous, online survey was used to collect data on information sources used for dosage decisions by veterinarians treating exotic species. Logistic regression models were built to identify associations between individual characteristics and primary outcomes.

RESULTS

Respondents reported their single most common source for establishing drug dosages as formularies (682/936 [72.9%]), followed by scientific journals (96 [10.3%]), other textbooks (68 [7.3%]), colleagues (47 [5.0%]), or continuing education notes (38 [4.1%]). Over two-thirds of the respondents (645, 68.9%) consulted a specific exotic animal formulary for establishing drug dosages in most situations. Of the 936 respondents, 407 (43.5%) reported that they sometimes (318 [34.0%]) or never (89 [9.5%]) checked the source of a dosage in a textbook or a formulary, 503 (55.3%) reported that they sometimes (399 [42.6%]) or never (104 [11.1%]) searched the original publication on a dosage, and 486 (51.9%) reported that they would base their dosage decision on the abstract of an article if they had no access to the full-text. Several respondents' reported characteristics were significant predictors of primary outcomes.

CLINICAL RELEVANCE

Considering our findings, we recommend authors of formularies and textbooks should focus on evidence-based information and state clearly when information is anecdotal. Tailored strategies to educate veterinarians treating exotic animals on the importance of primary sources are also recommended.

Evaluation of an evidence-based veterinary medicine exercise for instruction in clinical year of veterinary medicine program

INTRODUCTION

Evidence-based veterinary medicine (EBVM) is a fundamental core competency for new graduates. Our objectives were to evaluate clinical students' use, understanding of, and confidence in EBVM before undertaking an exercise consisting of an hour seminar in conjunction with a medical librarian, followed by a journal club and to evaluate students' knowledge of and ability to apply EBVM following the exercise.

METHODS

In this cohort study, students undertaking a large animal ambulatory rotation completed questionnaires before the seminar, following the journal club, and at graduation. Students took a Fresno test evaluating EBVM knowledge at the end of the rotation.

RESULTS

Prior to the seminar, 94% of students defined EBVM at least somewhat accurately, and 51% reported EBVM was at least 'quite important'. During previous rotations, 71% of students had performed literature searches to answer a clinician-assigned question; 89% had done this to answer their own questions. Students with previous research or EBVM training were more likely to perform self-directed literature searches. The most frequently used resource was textbooks. Eighty-seven per cent and 90% of students found the seminar and journal club, respectively, at least moderately useful in improving EBVM knowledge.

CONCLUSIONS

Our results support the inclusion of an EBVM exercise during the clinical year and suggest spaced repetition may be helpful in teaching this topic.

Therapeutics in Herd/Flock Medicine

When treatment is required for a herd/flock health concern, a range of factors must be considered to determine the preferred treatment strategy. If a group treatment strategy is pursued, considerations to optimize the likelihood of safe and effective group treatment include taxon-specific pharmacokinetics/pharmacodynamics, the formulation of prescribed medication, the type and amount of food, the number and type of water sources, enclosure design, size and demography of the group, weather conditions, and health status of individuals in the group. In addition, antimicrobial stewardship principles and relevant legislation/regulation must be at the forefront of decision making.

Veterinarian barriers to knowledge translation (KT) within the context of swine infectious disease research: an international survey of swine veterinarians

Background

Food animal veterinarians face commodity specific and urgent global challenges yet conditions preventing use of best available knowledge have been sparsely studied. The American Association of Swine Veterinarians (AASV) membership (N = 1289) was surveyed online to benchmark their information priorities and their motivations and sources for keeping current with infectious disease research, and to describe their reported time, skill, access, and process as barriers to knowledge translation (KT).

Results

Respondents (n = 80) were mostly from Canada (n = 40) and the U.S.A (n = 31) and demographics approximated the AASV’s. Colleagues are the first choice for information on difficult cases (49%, 95%CI: 38–61). Half of respondents (53%, 95%CI: 41–64) spend an hour or less per week keeping up with infectious disease research. The majority reported moderate or less than moderate efficiency (62%, 95%CI: 51–72), and moderate or greater stress (59%, 95%CI: 48–70) with their process for keeping up. Journal article methods sections are commonly not read, almost a third (32%, 95% CI: 22–43) reported either they do not evaluate statistical methods or that they had poor confidence to do so, and half (52, 95%CI: 41–63) could not explain ‘confounding bias’. Approximately half (55%, 95%CI: 41-69) with direct oversight of swine herds had full access to 2 or fewer academic journals. Approximately a third of respondents (34%, 95%CI: 24–46) selected only formats involving single research studies (either full text or summaries) as preferred reading materials for keeping current over expert summaries of the body of evidence.

Conclusion

KT barriers are considerable and a source of stress for many swine veterinarians. Sub-optimal efficiency with keeping up and low confidence to appraise aspects of research are concerns. Results are consistent with previous literature and illustrate need for improved KT infrastructure and for additional training in statistical methods and interpretation of primary research. Further evaluation is warranted of why approximately a third of veterinarians in this study, for the purpose of keeping up, preferentially choose to review individual research studies over choices that would include an expert summary of the body of evidence. Consideration of reasons for this preference will be important in the planning of KT infrastructure improvements.

Supplementary information

Supplementary information accompanies this paper at 10.1186/s12917-020-02617-8.

Exploring the loss and disenfranchised grief of animal care workers

This article explores the psychological distress of Animal Care Workers (ACWs), and the disenfranchisement of this distress through mixed methods study conducted as an online survey. In all, 139 participants responded about their experiences as an ACW, related psychological distress, and the systemic disenfranchisement of distress. Findings indicate that nearly half of ACWs experienced symptoms of depression in the previous month. Over 66% indicated it was difficult to cope. Limited support often resulted in a disenfranchized loss. Implications suggest ACW distress and disenfranchisement related to animals they serve is similar to that of individuals who lose animal companions.

Assessment of systematic reviews and meta-analyses available for bovine and equine veterinarians and quality of abstract reporting: A scoping review

OBJECTIVE

Evidence-based medicine (EBM) is used in various areas including veterinary medicine. The assessment of the quality of systematic review and meta-analyses (SR-MA) despite their importance in the EBM process is uncommonly performed in veterinary medicine due to the absence of specific dedicated tools. The main objective of this observational study was to examine the extent and nature of SR-MA that can be available online to an equine or bovine veterinarian. Secondary objectives included: (1) to determine if A MeaSurement Tool to Assess systematic Reviews (AMSTAR) tool can be used for equine and bovine SR-MA methodological assessment and if it has a satisfactory interrater reliability in a subsample of these SR-MA and (2) to appraise the completeness of abstract reporting of this sample.

STUDY DESIGN AND SETTING

A scoping review using equine and bovine medical science SR-MA retrieved from PubMed was performed. A sub-sample of these reviews (n = 30) were independently assessed by 3 different raters using the AMSTAR tool validated for medical reviews. The completeness of abstract reporting was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist.

RESULTS

Ten and 168 SR-MA were retrieved for equine and bovine species respectively. For bovine SR-MA, 93 reviews were about nutrition and metabolism topic. On the 30 SR-MA subsamples, with 10 equine and 20 bovine SR-MA randomly chosen for AMSTAR assessment, the median interrater agreement (Kappa) was 0.60 (interquartile range: 0.36-0.71) depending on AMSTAR item and pairs of raters. When focusing on the total score of AMSTAR, the inter-observer intra-class correlation coefficient was very good (0.85, 95% confidence interval (CI): 0.74-0.92). The AMSTAR items that were unfrequently reported (33% or less of reviews) were "a priori" protocol of SR-MA specification, complete report of the list of studies (included and excluded studies), quality assessment of the included studies, publication bias assessment and conflict of interest (reported either for included studies and for SR-MA authors). Abstracts reporting quality was low with a median percentage of complete reported items of 33% (range: 8-58%) CONCLUSIONS: In large animal veterinary medicine, SR-MA are uncommonly performed in equine and bovine medicine. The SR-MA can be assessed using AMSTAR with acceptable inter-rater reliability, which is helpful to assess SR-MA methodological quality.

Essential and core books for veterinary medicine

Objectives

This study defined core and essential lists of recent, English-language veterinary medicine books using a data-driven methodology for potential use by a broad audience, including libraries that are building collections supporting veterinary sciences and One Health initiatives.

Methods

Book titles were collected from monograph citation databases, veterinary examination reading lists, veterinary college textbook and library reserve lists, and published bibliographies. These lists were combined into a single list with titles ranked by the number of occurrences.

Results

The methodology produced a core list of 122 monographs and an essential list of 33 titles. All titles are recent, edition neutral, English language monographs. One title is out of print.

Conclusions

The methodology captured qualitative and quantitative input from four distinct populations who use veterinary monographs: veterinary practitioners, educators, researchers, and librarians. Data were collected and compiled to determine core and essential lists that represented all groups. Unfortunately, data are not available for all subareas of veterinary medicine, resulting in uneven subject coverage. This methodology can be replicated and adapted for other subject areas.

Accessibility of published research to practicing veterinarians

Objectives

This study established the percentage of veterinary research articles that are freely available online, availability differences inside and outside of core veterinary medicine publications, sources and trends in article availability over time, and author archiving policies of veterinary journals. This research is particularly important for unaffiliated practitioners who lack broad subscription access and the librarians who assist them.

Methods

Web of Science citation data were collected for articles published from 2000–2014 by authors from twenty-eight accredited US colleges of veterinary medicine. A sample of these articles was searched by title in Google Scholar to determine which were freely available online and their sources. Journals represented in this dataset and a basic list of veterinary serials were cross-referenced with the Sherpa/RoMEO database to determine author archiving policies and the percentage of articles that could potentially be made freely available.

Results

Over half (62%) of the sample articles were freely available online, most of which (57%) were available from publishers’ websites. Articles published more recently were more likely to be freely available. More articles were found to be available in 2017 (62%) than in 2015 (57%). Most (62%) of the included journals had policies allowing authors to archive copies of their articles.

Conclusions

Many articles are freely available online, but opportunity exists to archive additional articles while complying with existing copyright agreements. Articles in veterinary medicine–specific journals are less likely to be freely available than those in interdisciplinary journals. Requirements for federally funded research have likely influenced article availability and may continue to do so.

The Educated Guess: Determining Drug Doses in Exotic Animals Using Evidence-Based Medicine

Lack of species-specific pharmacokinetic and pharmacodynamic data is a challenge for pharmaceutical and dose selection. If available, dose extrapolation can be accomplished via basic equations. If unavailable, several methods have been described. Linear scaling uses an established milligrams per kilograms dose based on weight. This does not allow for differences in species drug metabolism, sometimes resulting in toxicity. Allometric scaling correlates body weight and metabolic rate but fails for drugs with significant hepatic metabolism and cannot be extrapolated to avians or reptiles. Evidence-based veterinary medicine for dose design based on species similarity is discussed, considering physiologic differences between classes.

Information Resources for the Exotic Animal Practitioner

An essential component of evidence-based practice is finding the best available evidence to answer a clinical question. Finding evidence is difficult for veterinarians in general, and exotic animal clinicians in particular, owing to the lack of studies that provide a high level of clinically relevant evidence and limited access to resources. Knowing where and how to search for evidence can facilitate evidence-based practice.

The Awareness of the International Veterinary Profession of Evidence-Based Veterinary Medicine and Preferred Methods of Training

Evidence-based veterinary medicine (EVM) is an evolving discipline in veterinary medicine so it is important to periodically “benchmark” opinion about EVM across the profession. An international survey to assess veterinarians’ awareness of EVM was conducted. Veterinarians were surveyed via an online questionnaire (all countries) or a postal questionnaire (UK only). Participants were asked whether they had heard of EVM, where they had first heard the term, and their preferences of method for receiving continuing professional development (CPD). There were 6310 respondents, of which 4579 (72.5%) worked in the UK and 5384 (85.3%) were clinicians. Veterinarians that had heard of EVM (n = 5420, 85.9%) were most likely to be clinicians (OR = 4.00; 95% CI: 3.37, 4.75), respondents working in the UK (OR = 1.32; CI: 1.13, 1.54), or respondents with a postgraduate degree or qualification (OR = 1.77; CI: 1.51, 2.08). The most common sources from which respondents had heard of EVM were at vet school or university (n = 1207, 29.8%), via literature (peer-reviewed papers or other publications) (n = 1074, 26.5%), and via CPD courses (n = 564, 13.9%). Most respondents were interested in finding out more about EVM (n = 4256 of 6173, 69%). The preferred methods of CPD were day or evening seminars (n = 2992 of 6017, 49.7%), conferences (n = 1409, 23.4%), and online courses (n = 524, 8.7%), although the order of preference differed slightly between groups. There appears to be substantial awareness of EVM amongst veterinarians internationally. However, it appears that further training in EVM would be welcomed. Preferences on how CPD in general is received differs between groups, so this should be borne in mind by training providers when formulating a strategy for the dissemination of EVM training across the global profession.