Critical analysis of articles

RE: Critical analysis of articles

Anthony Todd — Fri, 24 Feb 2017 17:11:13 GMT

[quote user="Wren"]This drives me mad. I have spent years trying to educate clients to stop thinking like this.[/quote]

Sorry I don't understand. Can you explain please.

RE: Critical analysis of articles

Bob Russell — Fri, 24 Feb 2017 11:18:47 GMT

Sad in that the research done is too small a study to be sure that results are significant. Could be said that the small study resulting in animal experimentation that was of little value therefore better to do a larger study or none!

RE: Critical analysis of articles

Sarah Keir — Fri, 24 Feb 2017 10:28:17 GMT

And it is estimated that 85% of research is not published at all!

RE: Critical analysis of articles

Beats — Fri, 24 Feb 2017 10:20:21 GMT

It'll not be long before trends change and the calls to arms for EBVM (whatever that might be) and all studies ending in the conclusion "more research is required" are replaced by calls to arms for "individual medicine" or whatever trendy term catches on for a new fashion (N=1 medicine? after https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1268200/pdf/cmaj00175-0035.pdf )

[quote user="Bob Russell"]Sadly some of the studies discussed were very small populations of dogs.[/quote]

This is not necessarily sad. If you are against animal experimentation as I expect most vets are, then most studies you are going to read are observational ones, and if they are large-scale then by definition they have usually serious funding which means serious source of bias to contend with. Studies free from significant bias are almost always going to be pretty small and are often the distilled observations and wisdom of those with more experience than yourself and are worth (albeit critically) reading. I started using mirtazapine at 1/8th x 15mg tablet once daily as appetite stimulant in cats based on a study on what, 15 cats or something; I have been pleased with results; the more subtle an observed effect is, the more mega the trial to spot it needs to be...

RE: Critical analysis of articles

Bob Russell — Fri, 24 Feb 2017 09:53:24 GMT

There was a brief snippet on the evening Radio 4 news last night that suggested large amounts of human research was not repeatable by other workers!

It seems most information is at least a bit dodgy and perhaps years of practical experience is more important than some believe.

I went to a CPD evening on pancreatitis and came out knowing less than I did when I went in! Sadly some of the studies discussed were very small populations of dogs.

RE: Critical analysis of articles

Wren — Fri, 24 Feb 2017 08:51:49 GMT

[quote user="Anthony Todd"]If NSAIDs abate the symptoms they could be very unhelpful, as they mask pain etc.[/quote]

This drives me mad. I have spent years trying to educate clients to stop thinking like this.

RE: Critical analysis of articles

Nicola Cole — Thu, 23 Feb 2017 22:46:45 GMT

Quoting papers without reading them is a bit of a bug-bearer of mine as well. It would be lovely to base clinical decisions for drug choices or whatever on large scale, double blinded trials etc. However, certainly within veterinary medicine, there aren't that many of those. This leaves us often with studies with very small numbers of patients and numerous confounders within the studies. With studies such as those this can then potentially show us a trend but using them as 'evidence' of best protocol holds little weight. Many authors will actually say things like 'shows an interesting link but further studies needed to assess significance'.

Even within human medicine (extrapolating them to veterinary use) there are numerous papers which hold very little scientific weight out there, which you would not know are limited unless you actually read the whole paper.

I'm not saying to ignore these papers but using them as 'here's the evidence, use it' is unfortunately not as straight forward as that (in my opinion).

RE: Critical analysis of articles

Anthony Todd — Thu, 23 Feb 2017 18:17:01 GMT

[quote user="robloxley"]I thought your no. 1 argument was that the aim of treatment was to get the patient better, not necessarily to get a diagnosis??[/quote]

It was, always, and a BS AB might but, sure as 'ell NSAID's won't, and may even cause more problems, yet they are good practice, it seems.....

If the animal improves, just continue the AB....., if not have another look or refer [these days] if it's beyond you, simple really.

Where are you when the NSAIDs stop and the animal is just as bad?

[er, sorry "B12 and Bets" really, even I admit, was an approach fashionable in Wellington Rd in the 60s but not seen since then]

[Be nice to see some stats in these practices where "the boss" is a steroid and BS AB "sort of vet" and just count how often he/she is wrong or in trouble]

RE: Critical analysis of articles

Rob Loxley — Thu, 23 Feb 2017 17:22:20 GMT

[quote user="Anthony Todd"]If NSAIDs abate the symptoms they could be very unhelpful[/quote]

I thought your no. 1 argument was that the aim of treatment was to get the patient better, not necessarily to get a diagnosis??
I've long since come to the conclusion there's no pleasing you!

RE: Critical analysis of articles

Anthony Todd — Thu, 23 Feb 2017 17:04:22 GMT

[quote user="Anthony Dennison"]1) It's a human study. Not a veterinary one[/quote]

Yes but, as I've said, there aren't any vet. studies and it's very likely that the same observations will apply [see my previous posts]

Either way it sounds as if use of NSAIDS in humans, and probably dogs, just for the sake of doing something, may not be as safe as everyone assumes and, as NSAIDs have no therapeutic action, it may be better to do the dinosaureal thing of giving something, like a BS antibiotic which seems to have some logic and few side effects and therefore may make more sense.

If NSAIDs abate the symptoms they could be very unhelpful, as they mask pain etc.

The other thing it shows is the trouble you get into [er, me] if you don't read the whole paper.....

But hey-ho NSAIDs are in vogue now so who am I to demur.