A tale of two studies – research in clinical practice

A media briefing at 11.30am on Thursday 4th April at BSAVA Congress will focus on two studies, published in this month’s issue of Journal of Small Animal Practice (JSAP), that address topics of high importance in primary care practice:

Prospective randomised blinded clinical trial assessing effectiveness of three dental plaque control methods in dogs (Allan et al); and,

A comparison of the rates of postoperative complications between dogs undergoing laparoscopic and open ovariectomy (Charlesworth et al).

Both these articles, which are free to read online during BSAVA Congress, have potential to lead to improved health and welfare outcomes for huge numbers of dogs but, in the real world, will these articles change clinical practice?  At the briefing the authors will put their findings into context, and explain their experience of carrying out research in their practices, in discussion with Professor Nick Jeffery, Editor of JSAP.

The study by Allan et al compares the ability of tooth brushing, a specialty dental diet and everyday dental chews to minimise recurrence of plaque after dogs have had a veterinary tooth cleaning session. The outcome defined tooth brushing as superior to the other methods and, because of the careful design, there is little reason to doubt the face value of the results.

“This study is an impressive example of how it is possible to carry out high quality clinically-relevant research in primary care practice,” said Nick Jeffery. “It provides very strong evidence in favor of recommending tooth brushing following veterinary dental cleaning.”

The article by Charlesworth et al aimed to compare wound healing complication rates after ovariectomy by laparascope or open surgery. Wound healing complications were infrequent in both groups, but notably more so in the laparascopic group.  Although it had a very different set-up compared with the dental cleaning study, this study also provides clinically useful evidence. “For some medical procedures it can take a while before it is widely recognised that a randomised controlled trial is required to answer a question about clinical effectiveness,” said Nick.  “Perhaps laparascopic ovariectomy is one of those interventions – the authors lay out their evidence with great clarity and thereby contribute to this on-going discussion. “

So … what are the implications of these studies?  The interpretation of such work depends on an understanding of the study design and how the findings can be applied in practice. “Frequently the conclusion is that there is a need for further studies,” said Nick. “The work of research is endless! The allowance of time for research is so highly valued by private practice specialists that, in the USA, it is now built into their contracts. Perhaps some primary care practitioners would appreciate similar opportunities?”

The media briefing will discuss these issues as part of JSAP’s commitment to encouraging research in veterinary clinical practice.