EVBM
Cockcroft, P. P., & Holmes, M. M. (2003). Handbook of evidence-based veterinary medicine.
Available online: http://catalog.library.colostate.edu/record=b4063966~S1
There is also a print copy in the Vet Library SF748.C635 2003
Enhancing Clinical Decision Making
In July-October 2015, JAVMA published a series of articles entitled Enhancing Clinical Decision Making. These articles outline different facets of integrating an evidence based approach into veterinary clinical setting.
- Larson RL, White BJ. Importance of the role of the scientific literature in clinical decision making. J Am Vet Med Assoc. 2015 Jul 1;247(1):58-64. doi: 10.2460/javma.247.1.58. PubMed PMID: 26086229The 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and with each passing day, the knowledge gained during one's veterinary school education becomes increasingly outdated.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
- Larson RL, White BJ. First steps to efficient use of the scientific literature in veterinary practice. J Am Vet Med Assoc. 2015 Aug 1;247(3):254-8. doi: 10.2460/javma.247.3.254. PubMed PMID: 26176724.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.
- White BJ, Larson RL. Systematic evaluation of scientific research for clinical relevance and control of bias to improve clinical decision making. J Am Vet Med Assoc. 2015 Sep 1;247(5):496-500. doi: 10.2460/javma.247.5.496. PubMed PMID: 26295554.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. - White BJ, Larson RL. Systematic evaluation of scientific research for appropriateness of data analysis to improve clinical decision making. J Am Vet Med Assoc 2015;247:759-762.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.
EVBM
- Holmes, M. A., & Ramey, D. W. (2007). An introduction to evidence-based veterinary medicine. Veterinary Clinics Of North America, Equine Practice, 23(2), 191-200. doi:10.1016/j.cveq.2007.03.001Evidence-based veterinary medicine is not impossible to practice, nor does it restrict its followers from using their best clinical judgment in individual case management. Based on the experiences in the various fields of human medicine, veterinarians should expect that the base of evidence for veterinary treatments is likely to expand rapidly, with positive expectations for improved treatment results. They would be well served by learning and applying evidence-based approaches to veterinary care, for the benefit of all who participate in the veterinarian-client-patient interaction.
- Kastelic, J. P. (2006). Critical evaluation of scientific articles and other sources of information: an introduction to evidence-based veterinary medicine. Theriogenology, 66(3), 534-542. doi:10.1016/j.theriogenology.2006.04.017The purpose of this paper is to briefly review key concepts regarding critical reading of the scientific literature to make informed decisions, in the context of evidence-based veterinary medicine. Key concepts are reviewed, based on the broader experience in human medicine, with adaptations, as indicated, to veterinary medicine. That a paper has been published in a peer-reviewed journal does not guarantee its credibility; guidelines are given regarding the general merit of different kinds of articles, as well as checklists and criteria that can be used to assess a paper. Specific study designs, their merits and limitations, are briefly discussed. Standard numerical indices for assessment of studies involving treatments and for assessments of diagnostic tests are summarized. Criteria for assessing drug trials are presented. The principles of statistical analysis are described, including practical considerations and common errors. Finally, numerous sources of bias are reviewed.
- Holmes, M. A. (2007). Evaluation of the evidence. Veterinary Clinics Of North America, Small Animal Practice, 37(3), 447-462. doi:10.1016/j.cvsm.2007.01.004Evaluating the evidence describes the scientific basis of evidence as presented in papers describing the results of clinical research. The types of errors that may lead to misinterpretation of evidence are discussed. This article includes descriptions of the main types of research performed in veterinary clinical research and notes on their advantages and disadvantages.
Librarian

Michelle Wilde
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Contact:
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Colorado State University
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Colorado State University
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Subjects: Zoology