As I get older my beliefs get firmer and slightly more ridiculous. For example, I honestly believe that if I met Ed Sheeran we would become lifelong and inseparable friends; I also believe that one day I will get to compete in Strictly Come Dancing, a la Judy Murray. Now, while I choose to consider these as truths, I do admit that I would have problems convicing you of their validity, and indeed my own family would also undoubtedly greet these assertions with disbelief. The fact is, I have no evidence to support my beliefs, and I am aware that this lack of evidence makes my assertions seem downright daft! But, my beliefs are harmless, no lives are at stake, and whether they are true or not is not important — not so where human and animal health are concerned.
Evidence is a vital part of both human and veterinary medicine. Evidence-based practice allows veterinary nurses to provide the best possible level of care. The evidence influencing patient care comes from research; it can be challenging for veterinary nurses to move away from the ‘this is how it has always been done’ approach to implement the findings of research in practice. Bridging the research–practice gap is not easy!
It is vital for veterinary nurses to carry out research to support the way they work; however, carrying out research alone is not enough. Research must be published in a peer-reviewed journal for several reasons — the scrutiny of the reviewers is invaluable for ensuring that the research methods used were appropriate and analysis of results was rigorous; and if research is not published the results are not properly disseminated.
Not all research reveals positive results — sometimes the results are negative, and these negative results can be as important as the positive ones. In the past, in human medicine in particular, it has been possible for negative results to be shamelessly concealed from the public by pharmaceutical companies concerned primarily with getting their products on the market. In an attempt to prevent this, clinical trials are now registered with databases such as ClinicalTrials.gov. The submission of adverse event information was initially optional, but has been required since September 2009 — a step forward towards transparency. In 2014, all clinical trials in the European Union had to be registered in a publicly accessible database, and all results published within a year of the trial ending.
Clinical research in human medicine is clearly more advanced than in veterinary medicine, and currently veterinary research is not subject to the same rigorous scrutiny. Indeed, an article published in Vet Record in 2017 revealed that ‘Reporting and communication of randomisation procedures is suboptimal in veterinary trials’ (Di Girolamo et al, 2017). Di Girolamo and colleagues evaluated randomisation mechanisms used in randomised controlled trials published in the leading veterinary journals — 7% of the trials defined as ‘randomised’ used methods that are considered non-random, while almost half of the trials did not report any mechanism of randomisation.
Despite this, I am tremendously proud of the research that we have published in The Veterinary Nurse — we have published more than 20 research articles over the years. It is a credit to you nurses that you are undertaking this research, and submitting it for publication. Keep up the good work!
So, while I am a firm believer in the necessity for evidence in practice, I will continue to practise the Samba round my kitchen in readiness for my Strictly debut!