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Agneta Egenvall discusses different study designs used in veterinary medicine, and how they affect the conclusions that can be drawn
IT may be said that veterinarians have the opportunity to practise evidence-based veterinary medicine (EBVM) from two worlds. More than other medical professionals they can base their knowledge on evidence from studies ranging from full-scale epidemiological to small experimental studies. The role of small-scale studies is not normally considered when practising evidence-based medicine, as usually only epidemiological evidence is considered to be effective for clinical use. However, in the real world where funding can be a problem for large-scale programmes, researchers can easily first try a small-scale study to test a hypothesis and then use the findings for a large-scale study. From this it can be said that smaller experimental studies can be a part of the evidence-based research process and to some extent also inform clinicians. For example, several researchers have looked at the biomechanics of lunging (a basic diagnostic tool for mild lameness in horses in clinical examinations) in a limited number of horses (Walker and others 2010, Hobbs and others 2011, Starke and others 2011), which can inform a clinician. However, larger, more epidemiological studies on lunging on broader samples, where, for example, breed, age and various surfaces can also be taken into account, should also be performed. There are many other small-scale studies that may be useful for practising EBVM, but in each case the context needs to be assessed. For example, when researching the literature on the prognosis of spinal meningioma in the dog, I found a sole case series (n = 34) that informed the decision to be made much more effectively than previous studies had done (Petersen and others 2008). However, for some other diseases, for example, guttural pouch mycosis in horses, it might be argued that there have been too many small case studies (Borges and Watanabe 2011 …
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