Why use scientific literature in clinical decision making?

Robert Larson, DVM, PhD, DACT, DACVPM (Epidemiology), DACAN

Professor, Production Medicine; Edgar E. and M. Elizabeth Coleman Chair Food Animal Production Medicine; Executive Director, Veterinary Medical Continuing Education; College of Veterinary Medicine, Kansas State University

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The human mind is pretty good at properly linking cause-and-effect when the initiating cause and outcome are easily detected with human senses, straightforward with no interactions, and closely spaced in time, location, and magnitude. However, if either a causative factor or its outcome is undetectable by human senses aided by technology; or if multiple causes either must or can interact to bring about the outcome, the human mind makes many erroneous conclusions.

Many of these problems exist in veterinary medicine, in that nearly all causes of disease and repair are completely outside the ability of human senses to detect even when aided by advanced technology, the time-frame between a causative factor and a clinically important outcome can be prolonged (with many other visible factors occurring in the interim time), and very slight or undetectable changes in homeostatic mechanisms can result in profound changes in perceivable disease or repair outcomes (with more-easily detectable – but wholly non-influential changes occurring prior to disease or repair outcomes).

Fortunately, veterinary medicine can be a data-rich area of scientific investigation. Even though many of the factors affecting animal disease and repair are difficult or impossible to detect, the outcomes (recovery, length of life, improved growth, etc.) are readily measurable and occur within reasonable time frames. In a science like veterinary medicine, our investigations of nature can be data-driven because of the relative ease of collecting clinically important outcome data.

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