Study to determine clinical decision thresholds in small animal veterinary practice

Natalie Toulme Guevara, Erik Hofmeister, Mark H. Ebell, Isabella Locatelli

Research output: Contribution to journalArticle

Abstract

This study aimed to determine clinical decision thresholds for six common conditions in small animal veterinary practice. Participants were provided with an online survey. Five questions described scenarios of canine patients with suspected panosteitis, hypothyroidism, urinary tract infection (UTI), mechanical gastrointestinal obstruction (GIO) and idiopathic epilepsy, and one question described a feline patient with suspected chronic kidney disease. A range of probabilities was applied to each scenario. Test and treatment threshold levels were computed for each scenario from 297 usable responses. The test and treatment thresholds were determined for UTI (test=12.8 per cent; 95 per centCI=1.1 to 20.7; treatment=82.0per cent; 95 per centCI=66.3 to 100) and GIO (test=3.2 per cent; 95 per cent CI=0 to 10.4; treatment=87.3 per cent; 95 per centCI=82.6 to 93.5). All other scenarios did not provide data that allowed interpretable test and treatment thresholds. This pilot study has used a new approach in determining clinical thresholds in small animal medicine. Thresholds were successfully determined for two common conditions - canine mechanical GIO and canine UTI. Future research should broaden investigation of methods to determine group clinical threshold levels among veterinarians, which may be used as the basis for clinical decision rules.

Original languageEnglish (US)
Number of pages1
JournalVeterinary Record
Volume185
Issue number6
DOIs
StatePublished - Aug 10 2019

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urinary tract diseases
intestinal obstruction
Urinary Tract Infections
Canidae
animals
testing
dogs
Therapeutics
hypothyroidism
Veterinarians
epilepsy
Felidae
Hypothyroidism
kidney diseases
Chronic Renal Insufficiency
veterinarians
Epilepsy
medicine
Medicine
cats

Keywords

  • clinical practice
  • evidence-based medicine
  • small animals

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Study to determine clinical decision thresholds in small animal veterinary practice. / Guevara, Natalie Toulme; Hofmeister, Erik; Ebell, Mark H.; Locatelli, Isabella.

In: Veterinary Record, Vol. 185, No. 6, 10.08.2019.

Research output: Contribution to journalArticle

Guevara, Natalie Toulme ; Hofmeister, Erik ; Ebell, Mark H. ; Locatelli, Isabella. / Study to determine clinical decision thresholds in small animal veterinary practice. In: Veterinary Record. 2019 ; Vol. 185, No. 6.
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