THE winter meeting of the Association of Veterinarians in Industry (AVI) had the title: “I say conclusion, you say confusion – EBVM for the animal health industry”.
Held in Olympia prior to the London Vet Show, Nick Royle from RCVS Knowledge, Dr Rachel Dean from the Nottingham veterinary school, Paul Cooper from Assentra (a regulatory affairs consultancy), Debbie Doyle (a freelance technical writer) and Dr Jo McKelvie from Evita Services (clinical trial consultants) looked at EBVM from a number of standpoints and angles.
Nick Royle reminded the audience of the dangers of accepting, without question, the “opinions of experts”, which can often happen even when there is a body of contradictory evidence. He urged everyone to be constantly vigilant and questioning – no matter how entrenched the accepted version of events was.
Rachel Dean explained how the students at Nottingham were being constantly challenged to be evidence-based in their approach to veterinary medicine and surgery.
They are also encouraged to be highly sceptical when presented with so-called “evidence” by animal health companies wishing to show their products in the best possible light.
Given the nature of the audience, this viewpoint was challenged during question time. It was pointed out that members of NOAH were bound by a code of practice to ensure that promotional materials were not misleading or factually incorrect. However, it was accepted that vets and students should always expect to see the data behind every promotional claim.
Paul Cooper explained that the modern regulatory environment for veterinary medicines was increasingly tough, with very robust evidence having to be submitted and accepted by both national and EU regulatory authorities before products could obtain marketing authorisations and make medicinal claims.
As such the evidence base for such products was strong, he said, although it was recognised that the data held within marketing authorisation dossiers were not readily accessible to the general public or the veterinary profession and so added little to the body of evidence required for EBVM.
Debbie Doyle discussed the importance of critically appraising reference papers and making sure that statistical significance was not looked at in isolation.
Standard deviations, sample size and “impact scale” (a quality rating for scientific journals) were among many other factors that needed to be considered.
Debbie also challenged the importance and value of meta-analysis papers in the relatively limited veterinary literature – a view that was strongly endorsed by Rachel Dean.
Jo McKelvie talked about the value and the necessity of good clinical practice (GCP) when running clinical trials. As a result of the stringent guidelines required for GCP trials, the data generated were of extremely good quality and highly valuable, despite the fact it wasn’t always easily accessible to vets in practice (because of commercial sensitivity).
Overall, it was clear that vets needed to be more challenging and take an evidence-based approach in their clinical decision- making. As a consequence, animal health companies should be more “open” and expect to be questioned more extensively on the data they use to support products.
Animal health companies can contribute greatly to the database of evidence available to vets and in association with educational bodies help contribute to the drive for EBVM in the profession.
- See www.bva.co.uk/about_us/associationofvetsinindustry.aspx.