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Evidence Based Medicine in Small Animal Reproduction: current available literature
Arlt, S.; Dicty, V.; Heuwieser, W.
Clinic for Reproduction, Section of Production Medicine and Quality Management,
Freie Universität Berlin, Germany, www.tiergyn.de
In his decision making process in the daily veterinary practice the veterinarian should be driven by recent objective and scientifically proven information.
While in human medicine intensive examination of appraising available literature has been conducted in the course of evidence-based medicine (EBM), a systematically work up and appraisal of scientific publication has not been carried out in veterinary medicine yet. The aim of EBM is to base the decisions in the practice of medicine on valid, clinically relevant research data. By summarising information and analysing the results of different clinical trials relating to a specific topic (metaanalysis) concise and advanced conclusion can be formulated. This evidence (certainty that results are true) sets decision making on diagnosis, prognosis, treatment, and risk on the basis of more predictable outcomes.
The objective of this project was to search for published literature on reproduction in dogs and evaluate it in regard to evidence. For this purpose a literature research on online databases PubMed and Vet-CD as well as in the bibliographies of obtained articles was conducted. For appraising the literature 40 criterions in the categories material and methodology, study design, statistics, presentation and information content, practical applicability and conclusions were developed. Subsequently the criterions were integrated in a questionnaire. This tool can help the practitioner to identify articles with strong evidence and utilise information with high quality. You can find the whole questionnaire on the website www.tiergyn.de.
The search of veterinary literature of high evidence was difficult. Out of 287 appraised publications only 90 could be classified as clinical trials (31.4 %). The remaining 197 publications (68.6 %) were case reports or contained information based on personal experience. Metaanalyses could not be found in the literature of reproduction in dogs. In half of the cases (49.8 %) generally accepted and science-based conclusions could not be legitimately drawn by the collected data.
For the field of reproduction in dogs this project discovered evidence deficits. The demand for more clinical trials of a higher quality is obvious ? even though it is not easy to develop study protocols of high quality in the field of small animal reproduction (e.g. small number of dogs available fitting the inclusion criteria, missing compliance of the owners, individual differences and costs). It has to be assumed that also in other areas of veterinary medicine decisions are often based on sources of doubtful evidence.