Explanation and Elaboration Document for the STROBE‐Vet Statement: Strengthening the Reporting of Observational Studies in Epidemiology—Veterinary Extension

The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement was first published in 2007 and again in 2014. The purpose of the original STROBE was to provide guidance for authors, reviewers, and editors to improve the comprehensiveness of reporting; however, STROBE has a unique focus on observational studies. Although much of the guidance provided by the original STROBE document is directly applicable, it was deemed useful to map those statements to veterinary concepts, provide veterinary examples, and highlight unique aspects of reporting in veterinary observational studies. Here, we present the examples and explanations for the checklist items included in the STROBE‐Vet statement. Thus, this is a companion document to the STROBE‐Vet statement methods and process document (JVIM_14575 “Methods and Processes of Developing the Strengthening the Reporting of Observational Studies in Epidemiology—Veterinary (STROBE‐Vet) Statement” undergoing proofing), which describes the checklist and how it was developed.     

Explanation and Elaboration Document for the STROBE‐Vet Statement: Strengthening the Reporting of Observational Studies in Epidemiology – Veterinary Extension

The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement was first published in 2007 and again in 2014. The purpose of the original STROBE was to provide guidance for authors, reviewers and editors to improve the comprehensiveness of reporting; however, STROBE has a unique focus on observational studies. Although much of the guidance provided by the original STROBE document is directly applicable, it was deemed useful to map those statements to veterinary concepts, provide veterinary examples and highlight unique aspects of reporting in veterinary observational studies. Here, we present the examples and explanations for the checklist items included in the STROBE‐Vet Statement. Thus, this is a companion document to the STROBE‐Vet Statement Methods and process document, which describes the checklist and how it was developed.     

The REFLECT Statement: Methods and Processes of Creating Reporting Guidelines for Randomized Controlled Trials for Livestock and Food Safety by Modifying the CONSORT Statement†

The conduct of randomized controlled trials in livestock with production, health and food‐safety outcomes presents unique challenges that may not be adequately reported in trial reports. The objective of this project was to modify the CONSORT (Consolidated Standards of Reporting Trials) statement to reflect the unique aspects of reporting these livestock trials. A 2‐day consensus meeting was held on 18–19 November 2008 in Chicago, IL, USA, to achieve the objective. Prior to the meeting, a Web‐based survey was conducted to identify issues for discussion. The 24 attendees were biostatisticians, epidemiologists, food‐safety researchers, livestock‐production specialists, journal editors, assistant editors and associate editors. Prior to the meeting, the attendees completed a Web‐based survey indicating which CONSORT statement items may need to be modified to address unique issues for livestock trials. The consensus meeting resulted in the production of the REFLECT (Reporting Guidelines for Randomized Control Trials) statement for livestock and food safety and 22‐item checklist. Fourteen items were modified from the CONSORT checklist and an additional sub‐item was proposed to address challenge trials. The REFLECT statement proposes new terminology, more consistent with common usage in livestock production, to describe study subjects. Evidence was not always available to support modification to or inclusion of an item. The use of the REFLECT statement, which addresses issues unique to livestock trials, should improve the quality of reporting and design for trials reporting production, health and food‐safety outcomes.     

The REFLECT Statement: Methods and Processes of Creating Reporting Guidelines for Randomized Controlled Trials for Livestock and Food Safety

The conduct of randomized controlled trials in livestock with production, health, and food-safety outcomes presents unique challenges that might not be adequately reported in trial reports. The objective of this project was to modify the CONSORT (Consolidated Standards of Reporting Trials) statement to reflect the unique aspects of reporting these livestock trials. A 2-day consensus meeting was held on November 18–19, 2008 in Chicago, IL, to achieve the objective. Before the meeting, a Web-based survey was conducted to identify issues for discussion. The 24 attendees were biostatisticians, epidemiologists, food-safety researchers, livestock production specialists, journal editors, assistant editors, and associate editors. Before the meeting, the attendees completed a Web-based survey indicating which CONSORT statement items would need to be modified to address unique issues for livestock trials. The consensus meeting resulted in the production of the REFLECT (Reporting Guidelines for Randomized Control Trials) statement for livestock and food safety and 22-item checklist. Fourteen items were modified from the CONSORT checklist, and an additional subitem was proposed to address challenge trials. The REFLECT statement proposes new terminology, more consistent with common usage in livestock production, to describe study subjects. Evidence was not always available to support modification to or inclusion of an item. The use of the REFLECT statement, which addresses issues unique to livestock trials, should improve the quality of reporting and design for trials reporting production, health, and food-safety outcomes.     

Issues of reporting in observational studies in veterinary medicine

Observational studies are common in veterinary medicine; the results may be used to inform decision-making, future research, or as inputs to systematic reviews or risk assessment. To be of use, the results must be published, all of the outcomes that were assessed must be included in the publication, and the research (methods and results) must be reported in sufficient detail that the reader can evaluate the internal and external validity. In human healthcare, concerns about the completeness of reporting – and evidence that poor reporting is associated with study results – have led to the creation of reporting guidelines; these include the STROBE statement for observational studies.     

Results of a national survey of US veterinary college faculty regarding attitudes toward farm animal welfare

OBJECTIVE: To examine attitudes toward farm animal welfare among veterinary college faculty. DESIGN: E-mail survey. STUDY POPULATION: 157 US veterinary college faculty with large animal or food animal emphasis. PROCEDURE: Veterinarians from 27 US veterinary colleges were contacted via e-mail and asked to complete a 7-page survey relating to farm animal welfare issues. Thirty-one percent of those contacted responded. RESULTS: 71% of respondents self-characterized their attitude toward farm animal welfare as "we can use animals for the greater human good but have an obligation to provide for the majority of the animals' physiologic and behavioral needs." An additional 19% of respondents were more concerned about animal welfare than was indicated by that statement, and 10% were less concerned about farm animal welfare than was indicated by that statement. Significant relationships among demographic variables and attitude scores were observed, including more concerned attitudes among females, those with more liberal political views, and those who cited lower religiosity. No relationship between attitude and age was observed. CONCLUSIONS AND CLINICAL RELEVANCE: Veterinary college faculty have the opportunity to impact many stakeholders within the animal agriculture industries (eg, future veterinarians and policy makers looking for a veterinary science perspective). Results indicated that a considerable level of concern toward farm animal welfare is present in this population. Although the process of change may not be rapid, it is likely that the influence of these respondents will factor heavily into enhancing farm animal welfare.     

Workshop report: The 2012 Antimicrobial Agents in Veterinary Medicine: exploring the consequences of antimicrobial drug use: a 3‐D approach

Antimicrobial resistance is a global challenge that impacts both human and veterinary health care. The resilience of microbes is reflected in their ability to adapt and survive in spite of our best efforts to constrain their infectious capabilities. As science advances, many of the mechanisms for microbial survival and resistance element transfer have been identified. During the 2012 meeting of Antimicrobial Agents in Veterinary Medicine (AAVM), experts provided insights on such issues as use vs. resistance, the available tools for supporting appropriate drug use, the importance of meeting the therapeutic needs within the domestic animal health care, and the requirements associated with food safety and food security. This report aims to provide a summary of the presentations and discussions occurring during the 2012 AAVM with the goal of stimulating future discussions and enhancing the opportunity to establish creative and sustainable solutions that will guarantee the availability of an effective therapeutic arsenal for veterinary species.     

Expert opinion as 'validation' of risk assessment applied to calf welfare

Background

Recently, a Risk Assessment methodology was applied to animal welfare issues in a report of the European Food Safety Authority (EFSA) on intensively housed calves.

Methods

Because this is a new and potentially influential approach to derive conclusions on animal welfare issues, a so-called semantic-modelling type ''validation'' study was conducted by asking expert scientists, who had been involved or quoted in the report, to give welfare scores for housing systems and for welfare hazards.

Results

Kendall''s coefficient of concordance among experts (n = 24) was highly significant (P < 0.001), but low (0.29 and 0.18 for housing systems and hazards respectively). Overall correlations with EFSA scores were significant only for experts with a veterinary or mixed (veterinary and applied ethological) background. Significant differences in welfare scores were found between housing systems, between hazards, and between experts with different backgrounds. For example, veterinarians gave higher overall welfare scores for housing systems than ethologists did, probably reflecting a difference in their perception of animal welfare.Systems with the lowest scores were veal calves kept individually in so-called "baby boxes" (veal crates) or in small groups, and feedlots. A suckler herd on pasture was rated as the best for calf welfare. The main hazards were related to underfeeding, inadequate colostrum intake, poor stockperson education, insufficient space, inadequate roughage, iron deficiency, inadequate ventilation, poor floor conditions and no bedding. Points for improvement of the Risk Assessment applied to animal welfare include linking information, reporting uncertainty and transparency about underlying values.

Conclusion

The study provides novel information on expert opinion in relation to calf welfare and shows that Risk Assessment applied to animal welfare can benefit from a semantic modelling approach.     

The REFLECT Statement: Reporting Guidelines for Randomized Controlled Trials in Livestock and Food Safety: Explanation and Elaboration†

Concerns about the completeness and accuracy of reporting of randomized clinical trials (RCTs) and the impact of poor reporting on decision making have been documented in the medical field over the past several decades. Experience from RCTs in human medicine would suggest that failure to report critical trial features can be associated with biased estimated effect measures, and there is evidence to suggest that similar biases occur in RCTs conducted in livestock populations. In response to these concerns, standardized guidelines for reporting RCTs were developed and implemented in human medicine. The Consolidated Standards of Reporting Trials (CONSORT) statement was first published in 1996, with a revised edition published in 2001. The CONSORT statement consists of a 22‐item checklist for reporting a RCT and a flow diagram to follow the number of participants at each stage of a trial. An explanation and elaboration document not only defines and discusses the importance of each of the items, but also provides examples of how this information could be supplied in a publication. Differences between human and livestock populations necessitate modifications to the CONSORT statement to maximize its usefulness for RCTs involving livestock. These have been addressed in an extension of the CONSORT statement titled the REFLECT statement: Methods and processes of creating reporting guidelines for randomized control trials for livestock and food safety. The modifications made for livestock trials specifically addressed the common use of group housing and group allocation to intervention in livestock studies; the use of deliberate challenge models in some trials and the common use of non‐clinical outcomes, such as contamination with a foodborne pathogen. In addition, the REFLECT statement for RCTs in livestock populations proposed specific terms or further clarified terms as they pertained to livestock studies.     

American veterinarians' animal welfare limitations

American society is becoming increasingly interested in issues of animal welfare, and the public generally recognizes the need for guidance from experts in the field. Assessing an animal's welfare status requires a determination of the state of both its physical and its psychological well-being. American veterinarians are well trained to assess the physical state of most animals, but they do not receive equivalent training in assessing an animal's psychological state. Therefore, the recognized expertise of the American veterinary profession currently lies only in answering physical welfare questions, not in assessing the psychological (or societal) aspects of animal welfare issues. If American veterinarians wish to be seen as animal welfare experts, then it is critical for the profession to educate its members in assessing the psychological state of animals. Also, if the American Veterinary Medical Association wishes to be considered a leader in the field of animal welfare, it must partner with organizations with expertise in pertinent areas outside of the veterinary medical field to develop appropriate guidelines for American society, including the development of a widely accepted system for defining and determining overall animal welfare. If American veterinarians actively work to improve our strengths and combine them with those of experts in other fields, we can overcome our limitations as animal welfare experts and achieve wider acceptance as an important force for improving animal welfare.     

Consensus-based reporting standards for diagnostic test accuracy studies for paratuberculosis in ruminants

The Standards for Reporting of Diagnostic Accuracy (STARD) statement (www.stard-statement.org) was developed to encourage complete and transparent reporting of key elements of test accuracy studies in human medicine. The statement was motivated by widespread evidence of bias in test accuracy studies and the finding that incomplete or absent reporting of items in the STARD checklist was associated with overly optimistic estimates of test performance characteristics. Although STARD principles apply broadly, specific guidelines do not exist to account for unique considerations in livestock studies such as herd tests, potential use of experimental challenge studies, a more diverse group of testing purposes and sampling designs, and the widespread lack of an ante-mortem reference standard with high sensitivity and specificity. The objective of the present study was to develop a modified version of STARD relevant to paratuberculosis (Johne's disease) in ruminants. Examples and elaborations for each of the 25 items were developed by a panel of experts using a consensus-based approach to explain the items and underlying concepts. The new guidelines, termed STRADAS-paraTB (Standards for Reporting of Animal Diagnostic Accuracy Studies for paratuberculosis), should facilitate improved quality of reporting of the design, conduct and results of paratuberculosis test accuracy studies which were identified as "poor" in a review published in 2008 in Veterinary Microbiology.     

Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative

Background:  To comprehend the results of diagnostic accuracy studies, readers must understand the design, conduct, analysis, and results of such studies. That goal can be achieved only through complete transparency from authors.  Objective:  To improve the accuracy and completeness of reporting of studies of diagnostic accuracy to allow readers to assess the potential for bias in the study and to evaluate its generalisability.  Methods:  The Standards for Reporting of Diagnostic Accuracy (STARD) steering committee searched the literature to identify publications on the appropriate conduct and reporting of diagnostic studies and extracted potential items into an extensive list. Researchers, editors, and members of professional organisations shortened this list during a 2-day consensus meeting with the goal of developing a checklist and a generic flow diagram for studies of diagnostic accuracy.  Results:  The search for published guidelines on diagnostic research yielded 33 previously published checklists, from which we extracted a list of 75 potential items. The consensus meeting shortened the list to 25 items, using evidence on bias whenever available. A prototypical flow diagram provides information about the method of patient recruitment, the order of test execution and the numbers of patients undergoing the test under evaluation, the reference standard or both.  Conclusions:  Evaluation of research depends on complete and accurate reporting. If medical journals adopt the checklist and the flow diagram, the quality of reporting of studies of diagnostic accuracy should improve to the advantage of clinicians, researchers, reviewers, journals, and the public.     

A survey to determine public opinion about the ethics and governance of farm animal welfare

OBJECTIVE: To determine the attitude of the public toward farm animal welfare and identify beliefs regarding how decisions about farm animal welfare should be made. DESIGN: Telephone survey. STUDY POPULATION: A random sample of 1,019 US households. PROCEDURES: US households were contacted by telephone and asked to take part in a survey consisting of 48 items. RESULTS: A majority (437/773 [56.4%]) of respondents believed decisions about farm animal welfare should be made by experts rather than being based on the views of the public. Such advocates of expert decision making were less likely to believe the government should regulate farm animal welfare. Most (420/773 [54.3%]) respondents believed decisions about farm animal welfare should be based on scientific measures of animal well-being, as opposed to moral and ethical considerations. Those individuals who believed farm animal welfare decisions should be made by experts and be based on scientific measures were the least concerned about farm animal welfare issues. People who believed animal welfare decisions should be made by experts and be based on scientific measures were most responsive to information about use of gestation crates for sows. CONCLUSIONS AND CLINICAL RELEVANCE: These results should help increase recognition that changing public opinion is not simply a matter of convincing the public to support positions established by veterinarians and animal scientists. People's views about the role of the democratic process in regulating technologic change are important determinants of whether people accept the changes in animal agriculture that have occurred during the past century.     

Integrating animal welfare into veterinary education: using an online, interactive course

Veterinarians in the United States and abroad are faced with growing public concern for the welfare of animals, particularly those in production. To prepare veterinarians to exert the leadership expected by the public and industry, steps should be taken to provide instruction in animal welfare at veterinary colleges. The ultimate goal is to offer courses in animal welfare in a consistent manner on a global scale, utilizing existing expertise in an efficient and cost-effective manner. Given the intense curricula of veterinary schools and the scarcity of instructors trained in animal welfare, a nontraditional approach is needed to educate veterinary students in the United States and abroad in animal welfare. Michigan State University (MSU) is developing a graduate-level, online interactive course in animal welfare assessment. The course will approach the topic of animal welfare education from a holistic, multidisciplinary standpoint (encompassing ethics, economics, and behavior) and address issues important to the general public and the international community. The MSU course will draw on renowned international animal welfare experts, allowing students to receive high-quality education that would be difficult in any other circumstance. The course will bridge an important gap in the veterinary curriculum and offer a complete and congruous education in animal welfare to veterinarians worldwide. The MSU course will also serve as a model for collaboration in content assembly and course delivery, by using technology to leverage global expertise in the interests of educational equity. In addition to innovative technology, such as the use of Web-collaboration software to create the course, a variety of media that enable students to interact with the material will also be incorporated throughout the course. Thus, the course will not only utilize the Internet to provide access to high-quality material, but will also require the active participation of the student, which is needed for effective learning.     

Attitudes of Australian and Turkish veterinary faculty toward animal welfare

The attitudes of veterinary faculty toward animal welfare were surveyed in four Australian and three Turkish veterinary schools. The former were considered to be typical of modern Western schools, with a faculty of more than 40% women and a primary focus on companion animals, whereas the latter were considered to represent more traditional veterinary teaching establishments, with a faculty of 88% men and a primary focus on livestock. A total of 116 faculty responded to the survey (42 Australian and 74 Turkish faculty members), for response rates of 30% and 33%, respectively. This survey included demographic questions as well as questions about attitudes toward animal-welfare issues. Women were more concerned than men about animal-welfare issues, especially the use of animals in experiments, zoos, entertainment, and sports and for food and clothing. Total scores demonstrated different concerns among Turkish and Australian faculty. The study demonstrates that the veterinary faculty of these two countries have different concerns for animal welfare, concerns that should be acknowledged in considering the welfare attitudes that students may adopt.     

Factors influencing veterinary students career choices and attitudes to animals

The purpose of the study was to investigate the influence of demographic and experiential factors on first-year veterinary students career choices and attitudes to animal welfare/rights. The study surveyed 329 first-year veterinary students to determine the influence of demographic factors, farm experience, and developmental exposure to different categories of animals on their career preferences and on their attitudes to specific areas of animal welfare and/or rights. A significant male gender bias toward food-animal practice was found, and prior experience with particular types of animals--companion animals, equines, food animals--tended to predict career preferences. Female veterinary students displayed greater concern for possible instances of animal suffering than males, and prior experience with different animals, as well as rural background and farm experience, were also associated with attitude differences. Seventy-two percent of students also reported that their interactions with animals (especially pets) had strongly influenced the development of their values. Animals ranked second in importance after parents in this respect. The present findings illustrate the importance to issues of animal welfare of the cultural context of past experience and influences on attitude development. The results also suggest that previous interactions with animals play a critical role in guiding veterinary students into their chosen career, as well as in helping to determine their specific employment preferences within the veterinary profession. From an animal welfare perspective, the dearth of women choosing careers in food-animal practice is a source of concern.     

A SURVEY OF RADIOLOGISTS AND REFERRING VETERINARIANS REGARDING IMAGING REPORTS

An imaging report is a vital communication tool between a radiologist and clinician. In a field where in‐person communication may not be readily available, it is imperative that the report clearly relays pertinent clinical information in a timely manner. The purpose of this observational study was to describe and compare opinions and expectations of small animal general practitioners, veterinary specialists, and veterinary radiologists regarding the imaging report. Online surveys were distributed, and data were collected from 202 veterinary clinicians and 123 veterinary radiologists. The majority (89%) of clinicians were satisfied with their imaging reports and stated that they read the radiology report as soon as it was available (92%). Just less than half (48%) of clinicians indicated it was standard of care that a board‐certified veterinary radiologist read all imaging studies. Radiologists and clinicians agreed that a clinical history (98% and 94%, respectively) and clinical question (82% and 68%, respectively) were needed to generate a good radiology report. Fifty‐five percent to 70% of clinicians prefer red bulleted reports, which included incidental findings (96%); while radiologists slightly favored prose reporting (37–46%). Clinicians found it helpful when additional imaging (86%), medical (71%), and surgical recommendations (73%) were made. About one‐third of specialists who had been in practice for >11 years thought they were better able to interpret imaging for their own specialty than the radiologist. Clinicians voiced discontentment with reports that were not completed in a timely manner or did not give a prioritized differential list. Further studies are warranted to provide a more in‐depth evaluation of veterinary radiology reporting structure and style.