Guidelines for resident training in veterinary clinical pathology. III: cytopathology and surgical pathology

The Education Committee of the American Society for Veterinary Clinical Pathology has identified a need for improved structure and guidance of training residents in clinical pathology. This article is the third in a series of articles that address this need. The goals of this article are to describe learning objectives and competencies in knowledge, abilities, and skills in cytopathology and surgical pathology (CSP); provide options and ideas for training activities; and identify resources in veterinary CSP for faculty, training program coordinators, and residents. Guidelines were developed in consultation with Education Committee members and peer experts and with evaluation of the literature. The primary objectives of training in CSP are: (1) to develop a thorough, extensive, and relevant knowledge base of biomedical and clinical sciences applicable to the practice of CSP in domestic animals, laboratory animals, and other nondomestic animal species; (2) to be able to reason, think critically, investigate, use scientific evidence, and communicate effectively when making diagnoses and consulting and to improve and advance the practice of pathology; and (3) to acquire selected technical skills used in CSP and pathology laboratory management. These guidelines define expected competencies that will help ensure proficiency, leadership, and the advancement of knowledge in veterinary CSP and will provide a useful framework for didactic and clinical activities in resident‐training programs.     

Guidelines for resident training in veterinary clinical pathology. II. Hematology

BACKGROUND: The Education Committee of the American Society for Veterinary Clinical Pathology (ASVCP) identified a need for improved structure and guidance in training residents in clinical pathology. To begin to meet this need, guidelines for training in clinical chemistry were published in 2003. OBJECTIVE: The goal of this report is to define learning objectives and competencies in hematology, including coagulation and immunohematology. METHODS: These guidelines were developed and written with the input of ASVCP Education Committee members and peer experts. RESULTS: The primary objectives of training in hematology are: 1) to accrue a thorough, extensive, and relevant knowledge base of the types, principles, and properties of hematology tests and concepts of pathophysiology in animals; 2) to develop abilities to reason, think critically, communicate effectively, and exercise judgment in hematologic data interpretation and investigative problem-solving; and 3) to acquire technical and statistical skills important in hematology and laboratory operations. We also provide options and ideas for training activities and identify hematology resources useful for clinical pathology faculty and staff, training program coordinators, and residents. CONCLUSIONS: The guidelines define expected competencies that will help ensure proficiency, leadership, and the advancement of knowledge in veterinary hematology and provide a useful framework for didactic and clinical activities in resident-training programs. The learning objectives can readily be adapted to institutional and individual needs, interests, goals, and resources.     

Guidelines for resident training in veterinary clinical pathology. I. Clinical chemistry

Background: The Education Committee of the American Society for Veterinary Clinical Pathology identified a need for improved structure and guidance of clinical pathology resident training in clinical chemistry.
Objectives: The committee's goal was to develop learning objectives and competencies in knowledge, abilities, and skills in clinical chemistry; provide options and ideas for training activities; and identify clinical chemistry resources useful for clinical pathology faculty, training program coordinators, and residents.
Methods: Guidelines were developed and written with the input of Education Committee members and peer experts.
Results: The primary objectives of clinical chemistry training are: 1) to accrue a thorough, extensive, and relevant knowledge base of the types, principles, and properties of clinical chemistry tests and concepts of pathophysiology in animals; 2) to develop abilities to reason, think critically, and exercise judgment in clinical chemistry data interpretation, investigative problem-solving, and hypothesis-driven research; and 3) to acquire technical and statistical skills important in clinical chemistry and laboratory operations.
Conclusions: These guidelines define expected competencies that will help ensure proficiency, leadership, and the advancement of knowledge in veterinary clinical chemistry and provide a useful framework for didactic and clinical activities in resident training programs. The learning objectives can readily be adapted to institutional and individual needs, interests, goals, and resources.     

Effect of fasting duration on clinical pathology results in Wistar rats

Background: Fasting is an important preanalytical factor that may affect the interpretation of hematology and clinical biochemistry data in toxicology or pharmacology studies. Limited information is available on how the results may be affected by different durations of fasting. Objective: The purpose of this study was to assess the influence of fasting duration on clinical pathology results in male and female rats and to determine an optimum fasting time for preclinical studies. Methods: Male and female Wistar rats (10 each per group) were fasted for 0, 4, 8, 16, 24, and 48 hours. Changes in body weight and in the results of routine CBC and clinical chemistry analysis were evaluated by 1‐way ANOVA. Results: Body weight was significantly decreased by 4 hours of fasting in all rats, and hemoglobin concentration was significantly increased at 16 hours in male rats. Serum glucose and triglyceride concentrations in both sexes and cholesterol and high‐density lipoprotein‐C concentrations in female rats were also significantly decreased beginning at 16 hours. The creatinine concentration was increased in females after 16 hours of fasting. Serum alkaline phosphatase and alanine aminotransferase activities were significantly decreased after 8 hours in males and 16 hours in females. Conclusions: Fasting‐induced changes in clinical pathology results were consistent with hemoconcentration and altered nutrition and metabolic function. Most changes occurred at 16 hours, with minimal subsequent changes. Hence, a 16‐hour fasting duration may be recommended for preclinical studies involving clinical pathology measurements.     

Receiver-operating characteristic curves and likelihood ratios: improvements over traditional methods for the evaluation and application of veterinary clinical pathology tests

Receiver-operating characteristic (ROC) curves provide a cutoff-independent method for the evaluation of continuous or ordinal tests used in clinical pathology laboratories. The area under the curve is a useful overall measure of test accuracy and can be used to compare different tests (or different equipment) used by the same tester, as well as the accuracy of different diagnosticians that use the same test material. To date, ROC analysis has not been widely used in veterinary clinical pathology studies, although it should be considered a useful complement to estimates of sensitivity and specificity in test evaluation studies. In addition, calculation of likelihood ratios can potentially improve the clinical utility of such studies because likelihood ratios provide an indication of how the post-test probability changes as a function of the magnitude of the test results. For ordinal test results, likelihood ratios can be calculated on a category-specific basis from the empirical data or by using the slope of the line joining adjacent category limits on the ROC curve. For continuous test results, data need to be categorized into intervals for estimation of likelihood ratios, or they can be calculated as the slope (tangent) to the ROC curve at a unique test value. We use ROC analysis and calculate likelihood ratios to evaluate the performance of tests reported in 2 articles previously published in this journal.     

Establishment of the European College of Veterinary Clinical Pathology (ECVCP) and the current status of veterinary clinical pathology in Europe

After 5 years of development, the European College of Veterinary Clinical Pathology (ECVCP) was formally recognized and approved on July 4, 2007 by the European Board of Veterinary Specialisation (EBVS), the European regulatory body that oversees specialization in veterinary medicine and which has approved 23 colleges. The objectives, committees, basis for membership, constitution, bylaws, information brochure and certifying examination of the ECVCP have remained unchanged during this time except as directed by EBVS. The ECVCP declared full functionality based on the following criteria: 1) a critical mass of 65 members: 15 original diplomates approved by the EBVS to establish the ECVCP, 37 de facto diplomates, 7 diplomates certified by examination, and 5 elected honorary members; 2) the development and certification of training programs, laboratories, and qualified supervisors for residents; currently there are 18 resident training programs in Europe; 3) administration of 3 annual board-certifying examinations thus far, with an overall pass rate of 70%; 4) European consensus criteria for assessing the continuing education of specialists every 5 years; 5) organization of 8 annual scientific congresses and a joint journal (with the American Society for Veterinary Clinical Pathology) for communication of scientific research and information; the College also maintains a website, a joint listserv, and a newsletter; 6) collaboration in training and continuing education with relevant colleges in medicine and pathology; 7) development and strict adherence to a constitution and bylaws compliant with the EBVS; and 8) demonstration of compelling rationale, supporting data, and the support of members and other colleges for independence as a specialty college. Formal EBVS recognition of ECVCP as the regulatory body for the science and practice of veterinary clinical pathology in Europe will facilitate growth and development of the discipline and compliance of academic, commercial diagnostic, and industry laboratories in veterinary clinical pathology. Future needs are in developing sponsorship for resident positions, increasing employment opportunities, increasing compliance with laboratory, training, and continuing education standards, and advancing relevant science and technology.     

Business intelligence tools to optimize the appropriateness of the diagnostic process for clinical and epidemiologic purposes in a multicenter veterinary pathology service

Laboratory tests provide essential support to the veterinary practitioner, and their use has grown exponentially. This growth is the result of several factors, such as the eradication of historical diseases, the occurrence of multifactorial diseases, and the obligation to control endemic and epidemic diseases. However, the introduction of novel techniques is counterbalanced by economic constraints, and the establishment of evidence- and consensus-based guidelines is essential to support the pathologist. Therefore, we developed standardized protocols, categorized by species, type of production, age, and syndrome at the Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), a multicenter institution for animal health and food safety. We have 72 protocols in use for livestock, poultry, and pets, categorized as, for example, “bovine enteric calf”, “rabbit respiratory”, “broiler articular”. Each protocol consists of a panel of tests, divided into ‘mandatory’ and ‘ancillary’, to be selected by the pathologist in order to reach the final diagnosis. After autopsy, the case is categorized into a specific syndrome, subsequently referred to as a syndrome-specific panel of analyses. The activity of the laboratories is monitored through a web-based dynamic reporting system developed using a business intelligence product (QlikView) connected to the laboratory information management system (IZILAB). On a daily basis, reports become available at general, laboratory, and case levels, and are updated as needed. The reporting system highlights epidemiologic variations in the field and allows verification of compliance with the protocols within the organization. The diagnostic protocols are revised annually to increase system efficiency and to address stakeholder requests.     

兽用B超在母猪早期妊娠监测中的临床应用及效益分析

超声波扫描技术具有无损伤、无放射性危害、诊断准确率高、重复性好、安全无副作用、易操作等特点。本文探讨了超声波扫描在母猪早期妊娠监测中的应用、探测方法、诊断标准及效益分析。结果表明：超声探查技术能够直接对妊娠动物的妊娠诊断、胎龄判定、胎儿活力、胎儿数目及胚胎早期死亡或流产做出直观、准确的诊断,相对传统诊断技术具有明显优势。     

Use of participatory epidemiology to compare the clinical veterinary knowledge of pastoralists and veterinarians in East Africa

Because of severe resource and logistical constraints in large areas of Africa, disease surveillance systems need to maximize the use of information provided by livestock keepers and make correct interpretations of indigenous livestock knowledge. This paper describes the use of participatory epidemiology (PE) to compare the names, clinical signs and epidemiological features of cattle diseases as perceived by pastoralists and veterinarians. Using results from two previous studies with pastoralists in southern Sudan and Kenya, provisional translations of local disease names into modern veterinary terminology were used to develop a matrix scoring method for use with veterinarians. Matrix scoring data from pastoralists and veterinarians were then compared using simple visual comparison of summarized matrices, hierarchical cluster analysis and multidimensional scaling. The results showed good agreement between pastoralists' and veterinarians' disease names and diagnostic criteria. The matrix scoring method was easy to use and appropriate for use in under-resourced areas with minimal professional support or laboratory services. Matrix scoring could be used to assist livestock disease surveillance workers to design surveillance systems that make better use of pastoralist's indigenous knowledge and correctly interpret local disease names. The method should be combined with conventional veterinary investigation methods where feasible.     

Constructing naive Bayesian classifiers for veterinary medicine: A case study in the clinical diagnosis of classical swine fever

For diseases of which the clinical diagnosis is uncertain, naive Bayesian classifiers can be of assistance to the veterinary practitioner. These simple probabilistic models have proven to be very powerful for solving classification problems in a variety of domains, but are not yet widely applied within the veterinary domain. In this paper, naive Bayesian classifiers and methods for their construction are reviewed. We demonstrate how to construct full and selective classifiers from a data set and how to build such classifiers from information in the literature. As a case study, naive Bayesian classifiers to discriminate between classical swine fever (CSF)-infected and non-infected pig herds were constructed from data collected during the 1997/1998 CSF epidemic in the Netherlands. The resulting classifiers were studied in terms of their accuracy and compared with the optimally efficient diagnostic rule that was reported earlier by Elbers et al. (2002). The classifiers were found to have accuracies within the range of 67-70% and performed comparable to or even better than the diagnostic rule on the available data. In contrast with the diagnostic rule, the classifiers had the advantage of taking both the presence and the absence of particular clinical signs into account, which resulted in more discriminative power. These results indicate that naive Bayesian classifiers are promising tools for solving diagnostic problems in the veterinary field.