Power of practice: using clinical data to advance veterinary medicine

Lund, Elizabeth M.

doi:10.1136/vr.g7763

Cited by 2 publications

(1 citation statement)

References 7 publications

(7 reference statements)

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“…First opinion small animal veterinary practices are a valuable source of research data and, different 45 methods have been used to harness this data (Lund, 2015 consultation or a specific health problem consultation (Robinson et al, 2016). Data were gathered on 87 all problems discussed during each consultation, in the order they were discussed.…”

Section: Introduction 44mentioning

confidence: 99%

Accuracy of the electronic patient record in a first opinion veterinary practice

Jones-Diette

Robinson

Cobb

et al. 2017

Preventive Veterinary Medicine

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18The use of electronic patient records (EPRs) in veterinary research is becoming more common place. 19To date no-one has investigated how accurately and completely they represent the clinical 20 interactions that happen between veterinary professionals, and their clients and patients. The aim of 21 this study was to compare data extracted from consultations within EPRs with data gathered by direct 22 observation of the same consultation. A secondary aim was to establish the inter-rater reliability of 23 two researchers who examined the data extracted from the EPRs. A convenience sample of 36 small 24 animal consultations undertaken by 2 veterinary surgeons at a mixed veterinary practice in the United 25Kingdom was studied. All 36 consultations were observed by a single researcher using a standardised 26 data collection tool. The information recorded in the EPRs was extracted from the Practice 27 Management Software (PMS) systems using a validated XML schema. The XML extracted data was 28 then converted into the same format as the observed data by two independent researchers who 29 examined the extracted information and recorded their findings using the same tool as for the 30 observation. The issues discussed and any action taken relating to those problems recorded in the 31 observed and extracted datasets were then compared. In addition the inter-rater reliability of the two 32 researchers who examined the extracted data was assessed. 33Only 64.4% of the observed problems discussed during the consultations were recorded in the EPR. 34The type of problem, who raised the problem and at what point in the consultation the problem was 35 raised significantly affected whether the problem was recorded or not in the EPR. Only 58.3% of 36 observed actions taken during the consultations were recorded in the EPR and the type of action 37 significantly affected whether it would be recorded or not. There was moderate agreement between 38 the two researchers who examined the extracted data. This is the first study that examines how much 39 of the activity that occurs in small animal consultations is recorded in the EPR. Understanding the 40 completeness, reliability and validity of EPRs is vital if they are to continue to be used for clinical 41 research and the results to direct clinical care. 42

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Section: Introduction 44mentioning

confidence: 99%

Accuracy of the electronic patient record in a first opinion veterinary practice

Jones-Diette

Robinson

Cobb

et al. 2017

Preventive Veterinary Medicine

View full text Add to dashboard Cite

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Investigating preventive-medicine consultations in first-opinion small-animal practice in the United Kingdom using direct observation

Robinson

Cobb

Dean

2016

Preventive Veterinary Medicine

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Preventive-medicine consultations account for a large proportion of the veterinary caseload and previous research has suggested these consultations are fundamentally different from those in which the animal is presented for a specific health problem. There has been recent controversy around some aspects of preventive medicine for cats and dogs, and the full health benefits of the preventive-medicine consultation remain unclear. The aim of this study was to compare characteristics of the consultation and the problems discussed during the consultation between preventive-medicine consultations and other types of consultations. Data were gathered during direct observation of small-animal consultations in seven first-opinion practices in the United Kingdom. Data collected included type of clinical examination performed, patient signalment, and details of all problems discussed (including whether the problem was presenting or non-presenting, new or pre-existing, who had raised the problem, body system affected and whether an action was taken). A two-level multivariable logistic-regression model was developed, with canine and feline patients at Level 1 nested within consulting veterinary surgeons at Level 2, and a binary outcome variable of preventive-medicine consultation versus specific health-problem consultation. A total of 1807 patients were presented, of which 690 (38.2%) presented for a preventive-medicine consultation. Dogs were the most frequently presented species (n=1168; 64.6%) followed by cats (n=510; 28.2%), rabbits (n=86; 4.8%) and patients of other species (n=43; 2.4%). The five variables remaining in the multi-level model were whether multiple patients were presented, patient age, clinical examination type, weighing and number of problems discussed. Species, breed, sex, neutering status and practice did not remain in the final model. Many non-presenting problems, including both preventive-medicine problems and specific-health problems, were discussed and acted upon during all types of consultations. Dental and behavioural non-presenting problems were discussed more frequently during preventive-medicine consultations compared with specific health-problem consultations. Preventive-medicine consultations represent an opportunity for veterinary surgeons to discuss other aspects of preventive medicine, and to detect and manage new and ongoing health problems. A greater evidence base is needed to understand whether detecting and managing underlying disease during the preventive-medicine consultation has a positive impact on lifelong patient health and welfare.

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Power of practice: using clinical data to advance veterinary medicine

Cited by 2 publications

References 7 publications

Accuracy of the electronic patient record in a first opinion veterinary practice

Accuracy of the electronic patient record in a first opinion veterinary practice

Investigating preventive-medicine consultations in first-opinion small-animal practice in the United Kingdom using direct observation

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