Veterinary
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English (UK)
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Norsk bokmål
Veterinary
English (UK)
Español de Chile
Norsk bokmål
CAUTIOUSLY CONSIDER any treatment claims
There are always harms and benefits associated with any treatment, so it is important to consider objectively all aspects of any treatment claim. You should look out for:
• Unbalanced views
• Assumption-based claims
• Trust-based claims
Intervention is not always necessary; it can sometimes make a condition worse. It is important to consider the effects of allowing the animal’s body to heal by itself.
We can rarely, if ever, be certain about the effects of a treatment as there will always be limitations and risks involved.
It is important to consider all desired and undesired consequences of the treatments available in order to be able to make an informed decision.
Although something may appear to work ‘in theory’, this alone doesn’t mean it will actually be effective in practice.
Just because a link has been made between a treatment and an outcome, it does not mean that the treatment caused the outcome.
The results of a single study considered in isolation can be misleading.
A treatment that is new and/or technologically impressive is not necessarily better or safer. The same applies to older, well established treatments.
Increasing the dose or duration of treatment (or in some cases, decreasing) may not be beneficial and may be harmful.
Companies or individuals may exaggerate positive features and minimise negative features if they are going to benefit from the recommendation or use of the treatment.
Individual experiences and anecdotes alone are not a reliable basis for most treatment claims.
Opinions of experts, authorities, or other respected individuals may not necessarily be reliable sources when considered in isolation.
Publication of research in peer-reviewed scientific journals is not necessarily a guarantee of study design quality.
ALWAYS ASK about the evidence from treatment comparisons
Always enquire about the evidence that is used to support the efficacy of treatments for specific diseases or conditions. Not all evidence findings have been generated using robust research practices, sometimes resulting in questionable results. Look out for:
• Unfair or unequal comparisons of treatments
• How treatment effects are described
The animals and the circumstances within the research studies being considered should be as similar as possible to those animal(s) being treated.
Apart from the interventions being studied, all other factors, including animal groups, treatments, and study conditions for the groups being compared should be the same.
Reliable and valid methods should have been used to determine the outcomes of treatments.
The outcomes should be assessed in the same way for all animals in a study.
Abstracts alone do not provide evidence sufficient to base clinical decisions on.
There may be no evidence at all as to whether a treatment works or not. This is not the same as when there is evidence, but the evidence shows that the treatment has no effect.
Deeming results to be ‘statistically significant’ or ‘non-significant’ can be misleading and should be described in the context of the aim being investigated.
Studies involving small numbers of animals or people may be inaccurate and could misrepresent the ‘truth’.
Treatment effects that are only reported descriptively are not adequate. When statistically comparing groups, confidence intervals should be provided to determine the level of uncertainty about a finding.
CHOOSING IN CONTEXT is key for informed decision-making
Deciding what clinical decisions to make depends on understanding what the problems are, what outcomes are desired and how best these are achieved based on the evidence available. Think carefully about:
• Prioritising the key problems
• Balancing the options
Understand and describe what the problems are so that feasible options and acceptable outcomes can be clearly defined.
Weighing up the benefits and risks will enable decision-makers to choose appropriate treatment plans.
The possible advantages and disadvantages of a treatment should be considered, primarily in light of the welfare needs of the animal(s). The decision-making process should also include the context within which the animal(s) is cared for, the logistics of treatment, and the circumstances and values of the vet, practice, animal and owner.
