2. Why appraise?
2. Why appraise?
Scientific literature is extremely important, but not always entirely valid.
You may have heard the common phrase ‘Buyer, beware!’, but do we think this way about veterinary information? We should, particularly when it comes to the literature used to make evidence-based decisions about our patients.
Some projects assessing the quality of published literature in different fields of veterinary medicine have revealed substantial deficits in reported studies, even those in reputable peer-reviewed journals (Cockcroft, 2007; Kastelic, 2006; Simoneit et al., 2011).
You should keep this in mind when reading a paper, because you may find that conclusions formulated by authors are based on scientifically weak, if not invalid, data. Other papers may report information generated using inappropriate study designs (see Determine the level of evidence later in this section) which therefore result in questionable conclusions.
Questions to ponder:
What is the actual quality of the paper I am reading? Is it good enough to be able to incorporate the information into my clinical work?
Papers differ considerably, in both the relevance of information to real, practical scenarios, and the validity of presented data or results (Glasziou et al. 1998, Dean 2013). Even studies published in prestigious journals may have elements of bias, or be unreliable because of flaws in the design or conduct of the study. Study limitations are often described as part of the discussion section of a paper to aid interpretation of results, but this is not always the case. These same limitations apply to other information obtained, for example, via expert presentations, drug company leaflets, internet sources, etc. When appraising other information sources, it is important to be equally critical. Consider the origin of the information: who wrote it, and why?
Every practitioner aims to provide the best patient care, with the awareness of the importance of using diagnostic procedures and therapeutic interventions that are the most effective and that have an optimal risk:benefit ratio. In addition, as a practitioner, of course you want to be able to provide an owner with accurate information regarding the prognosis for their animal, and to take into consideration established risk factors for certain conditions in your diagnostic work-up.
In order to help you do these things in the best way possible using EBVM, this section will highlight the skills needed to appraise the quality of information available.