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Study to determine clinical decision thresholds in small animal veterinary practice
  1. Natalie Toulme Guevara1,
  2. Erik Hofmeister2,
  3. Mark Ebell3 and
  4. Isabella Locatelli4
  1. 1 Banfield Pet Hospital, Vancouver, Washington, USA
  2. 2 Department of Surgery, Midwestern University, Glendale, Arizona, USA
  3. 3 Department of Epidemiology and Biostatistics, University of Georgia, Athens, Georgia, USA
  4. 4 Department of Ambulatory Care and Community Medicine, Universite de Lausanne, Lausanne, Switzerland
  1. E-mail for correspondence; natalie.guevara{at}


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.

  • evidence-based medicine
  • small animals
  • clinical practice
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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval The University of Georgia Institutional Review Board approved the study (IRB ID: STUDY00003188).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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