CHECK THE INFORMATION SOURCE
Each month massive amounts of information on pet care is published in journals, magazines, and websites. Much of this information is very valuable, and much is worthless. Which pieces of information provide the best evidence upon which to base clinical decisions for pet care? How do we judge the validity of each piece of information?
Most people already realize that for human health care the information published in the New England Journal of Medicine is more reliable than the information that is obtained by rumors at the barbershop. Based on this common-sense thinking, we use several criteria to vet check any piece of medical information by asking the following questions:
- Is the source publication a peer-reviewed journal?
- Is the study blinded, and preferably double-blinded?
- Is the number of patients in the study large enough?
- If not a peer-reviewed publication is the information from conference proceedings?
- If from a conference proceeding, was the information the opinion of the presenter, or was unpublished research presented.
- Who paid for the presentation or the research? Is there a possibility of bias from a conflict of interest?
- Is it advice given by a veterinarian with no research to back it up?
- Is it based on personal practice experience?
In the perfect world, every clinical decision we make would be backed by not one double-blind study from a peer-reviewed journal, but several. To be honest, the research dollars allocated to veterinary clinical research are small enough to make such a perfect world completely unattainable.
So, we rely on the published record whenever possible, some conference proceedings when available, some lectures from learned colleagues, and when no other source is available, we rely on the clinical experience of our staff and fellow regional practitioners. We recognize, however, that the gold standard for medical information is still data that is presented from a double-blinded study that has a significant number of participants and that is published in a peer-reviewed journal. The other sources may, in fact, be helpful, but the validity of the data will always be suspect until confirmed by the gold standard.
It is important to remember that even blinded research can be tainted by bias, so we always look for possible conflicts of interest in a study. This can be hard to discover, and perhaps for obvious reasons; the organization that is promoting the information does not want a clear conflict of interest to be revealed. As an example, if a website or a publication is stating, emphatically, that a yearly heartworm test is essential to good health care for a dog, and we discover that the company that sells the most heartworm tests in the world is the sponsor of the website or the research, then we get suspicious about the claims.
Until the day that there is an organization in the veterinary field that establishes the service that Cochrane.org provides the human medical field, Veremedy vets will have to continue to sift through reams of medical information. Fortunately, at Veremedy, we are good at this, and we enjoy the challenge.