VM611 - Foundations of Veterinary Medicine

The volume of veterinary information is rapidly expanding, and with each passing day, the knowledge gained during one's veterinary school education becomes increasingly outdated. Veterinary practitioners face challenges when trying to build on existing clinical knowledge with additional information from the scientific literature to make better clinical decisions. Although veterinary medicine is built on scientific principles, incorporation of information from the scientific literature into clinical decision making is challenging for both new graduates and experienced practitioners. One of the largest obstacles is the amount of time required to accurately assess scientific information; however, a systematic approach to literature review enhances the usefulness of information gleaned from the literature and allows efficient use of one's time.1,2

Scientific literature can be used in veterinary practice to make better clinical decisions for the benefit of patients, clients, and society as a whole. Developments in the 20th and 21st centuries have provided tools that allow and compel veterinarians to move beyond simple clinical observations and experience when making judgments regarding health and disease of animals. Methods have been devised to control bias (systematic distortion of results away from the truth) and confounding (distortion of the apparent relationship between 2 variables by a third factor) in multiple types of research study designs, and these methods allow researchers to be more confident that study findings truly address their research questions. Advances in computing speed, creation of literature databases, and widespread availability of connectivity to the Internet have led to unprecedented access to information for veterinarians and their clients. All of these changes have made it essential that veterinarians develop skills to efficiently acquire, evaluate, and interpret a continuously growing body of scientific literature to support their clinical decisions.

Veterinary clinicians typically read the scientific literature to become better educated and thereby improve the quality of their clinical decisions. Whether this objective is met depends on the scientific validity of the studies evaluated and the similarity of the hypotheses tested to a specific clinical question. A focused approach to answering a specific clinical question or questions is important to avoid placing undue emphasis on preliminary data or extrapolating results beyond the populations to which they pertain. One approach to minimize potential misinterpretations and optimize time spent reading the literature is to use a strategic method of literature evaluation.

Veterinary clinicians have limited amounts of free time, and a streamlined method for selection and interpretation of the available literature on a given topic can increase the efficiency with which reported information is used to enhance clinical decision making. Clinicians learn strategies for performing thorough but efficient physical examinations by focusing on the problems most commonly encountered in practice, and a similar approach can be used to perform thorough but efficient literature evaluations. By focusing on the problems most commonly encountered in scientific research, clinicians can quickly identify research articles that can be immediately disregarded, thereby saving time and preventing the introduction of invalid information into the decision-making process. The purpose of the present article is to introduce the first 3 steps of a 5-step method for time-efficient literature evaluation designed to help clinicians obtain information to address a clinical question.

Many research articles published in well-respected journals describe studies with serious design flaws that limit their value for clinical decision making; therefore, it is important that clinicians critically evaluate the scientific literature they read.1 Methods have been developed to guide critical evaluation of published articles concerning randomized clinical trials2–4 and observational studies.5 The REFLECT2 (Reporting guidElines For randomized controLled trials for livEstoCk and food safety) and STROBE6 (STrengthening the Reporting of OBservational studies in Epidemiology) statements are guidelines intended to encourage standardized reporting of research and facilitate clinician evaluation of research integrity to gauge validity of the results. When clinicians are seeking to answer clinical questions, an effective and efficient systematic approach to evaluation of the scientific literature can reduce the amount of time spent reading the literature and minimize potential misinterpretation of research findings, thereby improving the value of the information gleaned.