Evaluation of the quality of current literature in the field of bovine, canine and equine reproduction and the manageability of its assessing by using a previously validated checklist
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Beschreibung
Diese Dissertation enthält Journal-Beiträge, die in der gedruckten Version nicht enthalten sind. Die entsprechenden DOIs sind angegeben, so dass die Beiträge gegen Gebühr herunter geladen werden können.
Evidence-based medicine (EBM) equips practitioners with skills to integrate high quality information from research in clinical decision making and improves the quality of health care (Rengerink et al. 2011).
The philosophical origin of EBM extends back to mid-19th century and earlier (Sackett et al. 1996). Since 1970 the implications of EBM have been debated more intensively in the literature as e.g. Cochrane published on the importance of randomized clinical trials (Cochrane 1972). Furthermore, technology - as computers and database software which allowed compilation of large amounts of data - has played a large role in the advancement of EBM (Claridge et al. 2005). However, the term EBM had been established many years later in 1992 by a Canadian workgroup at the McMaster University in Hamilton (Group 1992; Antes et al. 2006). Then in 1996, the term was more formally defined by Sacket et al. (Claridge et al. 2005) as ‘the conscientious, explicit and judicious use of current best evidence about individual patient care’ (Sackett et al. 1996).
Following the establishment of EBM in human medicine evidence-based veterinary medicine (EBVM) is the application of EBM to the veterinary field (Cockcroft et al. 2003). The concept of EBM had been transferred to veterinary medicine in the early 2000s (Vandeweerd et al. 2012a). Veterinarians are among other things responsible for the health and welfare of animals. In addition, veterinary medicine includes the care for health and life of humans regarding e.g. the compassion with owners, quality of food, zoonoses and scientific research. In conclusion, the quality of information used in veterinary decision making is of great importance.
In veterinary and human medicine, a great amount of time is spent in making diagnostic, therapeutic and preventive decisions (Vandeweerd et al. 2012d). Evidence-based veterinary medicine should rely on multiple sources of information (Kastelic 2006). In this regard veterinarians should use both individual clinical expertise and the best available external evidence, and neither alone is enough (Sackett et al. 1996). To receive external evidence one option would be to take evidence from literature and apply it in clinical practice. However, publications in veterinary journals vary widely in their quality (Kastelic 2006; Arlt et al. 2010). Studies of low quality should be used with caution. This necessitates that veterinarians reading published studies should be able to recognize and appreciate both the advantages and limitations inherent in the evidence generated by a variety of study designs (Vandeweerd et al. 2012d). Therefore, it is important to identify limitations in recent publications and to formulate recommendations for future studies. To demonstrate possibilities and weaknesses of publications an analysis on the quality of veterinary literature has to be done in general and species specific. Achieved results have to be introduced to other researchers and practitioners.
Being aware of the limitations of publications veterinarians have to assess the quality of literature before implementing information into the clinical practice. Hence, practicing EBVM requires clinical expertise, and expertise in retrieving, critically appraising, interpreting, and applying the results of published scientific studies (Arlt et al. 2011). However, a lack of understanding of some common terms concerning EBM exists (Yousefi-Nooraie 2007). In surveys of practicing veterinarians relating to their familiarity with the concepts of EBVM many practitioners did not express confidence in their understanding of common EBVMrelated terms (McKenzie 2011; Haimerl et al. in press). EBVM is rarely part of the education of German veterinarians (Arlt et al. 2012). Therefore, students may capture information without thinking about their quality. Information learned decades ago at university or in the early years at work has to be renewed over time. Because, in medicine, knowledge is rapidly changing and developing (Baum 2008). Furthermore, incorporation of EBM in practice faces several barriers to implementation e.g. lack of time (Rengerink et al. 2011). However, limited time to keep up to date with the current literature is not an adequate argument against the usefulness of EBVM (Vandeweerd et al. 2012d). Tools, like literature and databases with summarized information, to help students as well as practitioners to stay up to date for a lifetime would be beneficial. Furthermore, checklists have been developed to support the appraisal of the quality of literature. These tools could be useful to keep practitioners abreast of medical advances reported in veterinary literature. Furthermore, these checklists could help veterinarians to master terms important to EBVM. However, their usability for veterinarians has to be investigated.
Overall, the objectives of this thesis were 1) to discuss implementation of EBVM into veterinary medicine, 2) to evaluate and compare the quality of a randomly selected sample of literature on reproduction in cattle, dogs and horses and 3) to determine the inter-observer agreement utilizing a checklist for the evaluation of scientific literature in the field of animal reproduction.
Autor*in
Céline Simoneit