| Preface |
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xiii | |
| Acknowledgements |
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xiv | |
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1 | (22) |
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2 | (1) |
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2 | (1) |
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What do we mean by EBVM? A brief description |
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3 | (1) |
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Comparison of the traditional methods and EBVM |
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4 | (1) |
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Why should we practise EBVM? |
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4 | (7) |
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4 | (1) |
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Because our clients can too |
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5 | (1) |
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5 | (3) |
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Time for learning, a diminishing resource faced with expanding demands |
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8 | (1) |
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Increasing the speed of adopting the results of science |
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8 | (1) |
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To better direct clinical research |
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9 | (1) |
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9 | (1) |
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Ethical conduct in the absence of scientific evidence |
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10 | (1) |
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11 | (1) |
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Are we ready to ask questions about our own performance? |
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11 | (1) |
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A more detailed description of EBVM |
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11 | (3) |
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11 | (2) |
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13 | (1) |
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Other sources of information and evidence |
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14 | (1) |
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14 | (1) |
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EBM in veterinary medicine |
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15 | (1) |
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Are we already practising EBVM? |
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16 | (1) |
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16 | (3) |
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Small animals: megavoltage radiotherapy of nasal tumours in dogs |
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16 | (1) |
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Farm animals: restocking after foot and mouth disease |
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17 | (1) |
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Horses: efficiency of prednisolone for the treatment of heaves (COPD) |
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18 | (1) |
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How this book is organised |
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19 | (4) |
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The aims and objectives of this book |
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19 | (1) |
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Outline of the structure of this book |
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19 | (1) |
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References and further reading |
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20 | (2) |
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22 | (1) |
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Turning Information Needs into Questions |
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23 | (11) |
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24 | (1) |
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Refining clinical questions so that evidence can be found |
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24 | (1) |
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Is this a good treatment for a disease? |
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24 | (1) |
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24 | (1) |
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Four main elements of a well-formed clinical question |
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25 | (1) |
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25 | (1) |
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The diagnostic or therapeutic intervention, prognostic factor or exposure |
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25 | (1) |
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Comparison of interventions (if appropriate or required) |
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25 | (1) |
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26 | (1) |
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Categorising the type of question being asked |
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26 | (1) |
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Prioritising the questions |
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26 | (1) |
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Checklist of information needs |
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26 | (4) |
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Epidemiological risk factors |
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27 | (1) |
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27 | (1) |
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28 | (1) |
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29 | (1) |
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29 | (1) |
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Control (risk reduction) and prevention (risk avoidance) |
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30 | (1) |
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Potential pitfalls in constructing questions |
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30 | (1) |
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Complexity of the questions |
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30 | (1) |
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The need for sufficient background knowledge |
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31 | (1) |
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31 | (1) |
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Realistic targets for veterinary practice |
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31 | (1) |
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Evidence of quality control |
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31 | (3) |
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32 | (1) |
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33 | (1) |
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34 | (21) |
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35 | (1) |
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Background and foreground knowledge |
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35 | (1) |
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35 | (2) |
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Important traditional information resources |
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37 | (3) |
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37 | (2) |
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Textbooks and other review type publications |
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39 | (1) |
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Personal experience and background knowledge |
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39 | (1) |
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40 | (1) |
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40 | (1) |
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40 | (2) |
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Veterinary information resources on the Internet |
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42 | (9) |
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42 | (1) |
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43 | (1) |
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43 | (1) |
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International Veterinary Information Service |
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43 | (1) |
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44 | (4) |
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The Merck Veterinary Manual |
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48 | (1) |
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Montreal Veterinary School |
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48 | (1) |
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NetVet and the Electronic Zoo |
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49 | (1) |
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50 | (1) |
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50 | (1) |
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50 | (1) |
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Wildlife Information Network |
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51 | (1) |
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Other computer-based information resources |
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51 | (2) |
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52 | (1) |
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52 | (1) |
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52 | (1) |
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52 | (1) |
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Critically appraised topics |
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53 | (2) |
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53 | (1) |
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54 | (1) |
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55 | (12) |
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56 | (1) |
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56 | (1) |
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Other online book catalogues |
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56 | (1) |
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57 | (1) |
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Searching strategies: simple Boolean logic |
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57 | (1) |
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58 | (2) |
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Sensitivity and specificity |
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60 | (1) |
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Special veterinary considerations |
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60 | (1) |
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Searching for the answers to questions about therapy |
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61 | (1) |
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Searching for the answers to questions about diagnosis |
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62 | (1) |
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Searching for the answers to questions about aetiology |
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62 | (1) |
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Searching for the answers to questions about prognosis |
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62 | (1) |
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Using the `Clinical Queries' option in Pubmed |
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63 | (1) |
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Depth of the veterinary scientific literature |
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63 | (2) |
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Developing searching skills |
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65 | (2) |
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65 | (1) |
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66 | (1) |
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67 | (17) |
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Hierarchy of evidence and experimental design |
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68 | (1) |
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Guide to research methods |
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69 | (1) |
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69 | (2) |
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70 | (1) |
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70 | (1) |
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71 | (2) |
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Randomised controlled trials |
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71 | (2) |
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73 | (1) |
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73 | (5) |
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74 | (1) |
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75 | (1) |
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76 | (2) |
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Diagnostic tests and screening tests |
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78 | (1) |
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Poorly controlled or uncontrolled trials |
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78 | (1) |
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Comparisons between groups at different times |
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78 | (1) |
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Comparisons between different places |
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78 | (1) |
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n = 1 trials (the `treat and see' method) |
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79 | (1) |
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Uncontrolled trials (before and after trials) |
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79 | (1) |
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Non-random allocation trials |
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79 | (1) |
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79 | (5) |
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79 | (1) |
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Case series and case reports |
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80 | (1) |
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81 | (1) |
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82 | (2) |
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84 | (23) |
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Some introductory concepts |
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85 | (3) |
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The importance of statistics |
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85 | (1) |
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Likelihood: probability and odds |
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86 | (1) |
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87 | (1) |
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Appraising articles on veterinary therapy |
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88 | (5) |
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88 | (2) |
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Are the results important? |
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90 | (1) |
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Quantifying the risk of benefit or harm |
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90 | (2) |
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Confidence intervals (CIs) |
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92 | (1) |
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Making a decision about therapy |
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93 | (1) |
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Appraising articles on veterinary diagnosis |
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93 | (5) |
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94 | (1) |
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Are the results important? |
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95 | (3) |
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98 | (1) |
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Making a decision about a diagnostic test |
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98 | (1) |
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Appraising articles on harm or aetiology |
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98 | (4) |
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100 | (1) |
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Are the results important? |
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101 | (1) |
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102 | (1) |
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Appraising studies on prognosis |
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102 | (5) |
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103 | (1) |
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Are the results important? |
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104 | (1) |
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References and further reading |
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104 | (1) |
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105 | (1) |
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Solution to the probability example used in Section 1 |
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106 | (1) |
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107 | (18) |
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108 | (1) |
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108 | (2) |
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109 | (1) |
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The clinical examination: evidence for the presence of disease |
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110 | (1) |
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Hypothetico-deductive reasoning |
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111 | (1) |
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112 | (2) |
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114 | (2) |
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114 | (1) |
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114 | (1) |
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Pathophysiological reasoning (functional reasoning) |
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115 | (1) |
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Which method of pattern recognition is used? |
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116 | (1) |
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Clinical reasoning strategies used in hypothetico-deductive reasoning |
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116 | (2) |
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The properties of clinical signs |
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116 | (1) |
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Logical exclusion of a disease |
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117 | (1) |
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Inductive and deductive reasoning |
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117 | (1) |
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117 | (1) |
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118 | (1) |
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Errors in hypothetico-deductive reasoning |
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118 | (1) |
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Logic, sets, Venn diagrams, Boolean algebra |
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119 | (3) |
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Clinical sign sensitivities |
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120 | (1) |
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120 | (1) |
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Venn diagrams and Boolean algebra |
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120 | (2) |
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Clinical staging of metritis in cattle |
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122 | (3) |
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References and further reading |
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122 | (1) |
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123 | (2) |
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Clinical Diagnostic Decision Support Systems (CDDSSs) |
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125 | (29) |
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126 | (1) |
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126 | (1) |
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127 | (1) |
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Understanding the methodology used by CDDSSs |
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127 | (4) |
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128 | (1) |
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129 | (1) |
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Probabilities (Bayes' rule) |
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129 | (1) |
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Knowledge-based systems incorporating symbolic reasoning (syntactical systems) |
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130 | (1) |
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131 | (1) |
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131 | (1) |
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Sources of uncertainty or inaccuracies |
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131 | (1) |
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Evaluation of the performance of CDDSSs |
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132 | (1) |
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Which is the best method to measure the performance of a CDDSS? |
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132 | (1) |
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Alternative desirable indicators of performance using accuracy |
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133 | (1) |
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Veterinary diagnostic decision support systems |
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133 | (16) |
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A decision support algorithm for individual cow infertility |
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133 | (1) |
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134 | (4) |
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138 | (1) |
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PROVIDES (Problem Orientated Veterinary Information and Decision System) |
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138 | (3) |
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141 | (4) |
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145 | (1) |
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Cattle Disease Diagnostic System (CaDDiS) |
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146 | (1) |
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Application of probability techniques to the objective interpretation of veterinary clinical biochemical data |
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147 | (2) |
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Sources of information of the CDDSSs described in this chapter |
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149 | (5) |
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151 | (1) |
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152 | (2) |
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Decision Analysis, Models and Economics as Evidence |
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154 | (28) |
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155 | (1) |
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155 | (2) |
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Methods for clinical decision making |
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155 | (1) |
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Situations in which decision analysis may be helpful |
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156 | (1) |
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The five steps in decision analysis |
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156 | (1) |
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Disadvantages of decision analysis |
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157 | (1) |
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157 | (12) |
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158 | (1) |
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Solving the decision tree |
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158 | (1) |
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158 | (1) |
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158 | (1) |
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159 | (1) |
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Obtaining utility values from clients and owners |
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160 | (1) |
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Decision analysis tree for therapeutic decisions |
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161 | (1) |
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Decision analysis tree for economic decisions |
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161 | (2) |
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Decision analysis tree of diagnostic tests |
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163 | (3) |
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166 | (3) |
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User checklist for clinical decision analysis |
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169 | (1) |
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Testing and treating thresholds |
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169 | (2) |
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General properties of testing and treating thresholds |
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170 | (1) |
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171 | (5) |
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Modelling herd infection dynamics |
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172 | (2) |
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Modelling and the control of foot and mouth disease |
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174 | (1) |
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Modelling Staphylococcus aureus infection in a herd |
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175 | (1) |
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175 | (1) |
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176 | (2) |
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Partial budgets and cost--benefit analysis |
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176 | (2) |
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User guide to economic analysis |
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178 | (1) |
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178 | (4) |
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References and further reading |
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178 | (2) |
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180 | (2) |
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EBVM: Education and Future Needs |
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182 | (8) |
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183 | (1) |
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Resources for the practice of EBM |
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183 | (2) |
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Critically appraised topics (CATs) |
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183 | (1) |
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High quality systematic reviews |
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183 | (1) |
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184 | (1) |
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Secondary journals (e.g. EBM) |
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185 | (1) |
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EBM in veterinary education |
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185 | (1) |
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Evidence-based veterinary toolkit |
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185 | (1) |
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Finding out what is in the literature and what is not in the literature |
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185 | (1) |
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What resources do we need for the practice of EBVM? |
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185 | (1) |
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Clinical (EBVM) audits in veterinary practice |
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186 | (1) |
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What is a clinical audit? |
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186 | (1) |
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Why do we need a clinical audit? |
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186 | (1) |
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What has a clinical audit got to do with EBVM? |
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186 | (1) |
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How do we carry out an EBVM audit? |
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186 | (1) |
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Clinical audits and the future |
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187 | (1) |
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Other future developments |
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187 | (3) |
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References and further reading |
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188 | (2) |
| Glossary of Terms Used in EBVM |
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190 | (11) |
| Bibliography |
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201 | (3) |
| Answers to Review Questions |
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204 | (2) |
| Index |
|
206 | |
Other versions by this Author
