Clinical Decision Support and Technology: 9 Resources for Veterinarians
Veterinarians make important decisions every day, including diagnosing and determining the best course of action for each patient. Today, veterinary knowledge is rapidly expanding and changing. You want to help your patients in a timely manner, but you may second-guess your decision and take those worries home with you at night. These nine resources for clinical decision support can help put your mind at ease.
1. Continuing Education
Continuing education (CE) conferences, such as VMX and WVC, as well as local state meetings, provide excellent opportunities to learn about a wealth of information, including the latest guidelines, new diagnostics, and emerging treatment strategies. In addition, webinars and on-demand learning seminars are great options for veterinarians trying to maintain their CE credits while juggling a busy schedule.
2. Veterinary Textbooks
Many practitioners are prolific readers, and they turn to textbooks for diagnosis or treatment strategy guidance. Textbooks are a convenient and valuable tool for veterinarians, as long as they provide current information. In 2018, the National Library of Medicine published a list of 33 essential books for veterinary medicine, as well as 122 titles considered the profession's core books.
3. Veterinary Journals
Veterinary journals, such as the Journal of the American Veterinary Medical Association, provide current information about veterinary diagnostics and treatments, including the latest advances in a variety of subjects. Further, the Royal College of Veterinary Surgeons offers an online open-access journal that publishes content related to evidence-based veterinary medicine.
4. Clinical Practice Guidelines
Clinical practice guidelines (CPGs), which are curated by experts in the field, are a convenient tool to incorporate research evidence into clinical practice and provide information and best practices to diagnose and manage specific clinical conditions. CPGs must be updated regularly to remain relevant. Here are a few helpful CPGs:
The American Animal Hospital Association: AAHA recently updated its pain management guidelines for dogs and cats.
The American Heartworm Society: The AHS provides official guidelines to prevent, diagnose, and manage heartworm infections in dogs and cats.
The American College of Veterinary Internal Medicine: The ACVIM provides consensus statements to identify, evaluate, and manage systemic hypertension in pets.
The Reassessment Campaign on Veterinary Resuscitation: RECOVER provides evidence-based guidelines for veterinary cardiopulmonary resuscitation.
The International Renal Interest Society: IRIS supplies chronic kidney disease (CKD) guidelines.
5. Systematic Reviews
Systematic reviews, which provide a published summary and critical appraisal of research evidence on a particular topic, are a great way for busy veterinarians to gain current knowledge. Veterinarians can easily find systematic reviews by using VetSRev, a freely accessible online database produced by the Centre for Evidence-based Veterinary Medicine at the University of Nottingham.
6. Critically Appraised Topics
Critically appraised topics (CATs) summarize the published research literature on a specific topic. They are more narrowly focused and shorter than a systematic review. Organizations such as BestBETs for Vets provide CATs to answer specific clinical questions. Typical presentations include the following:
Clinical scenario: A clinical scenario describes a common situation faced by a veterinarian.
Three-part question: Specific questions are structured in three parts. If a clinical question differs from these issues, the evidence may not apply to the patient.
Literature search: Literature databases are searched, and the results are filtered to include relevant studies.
Summary: A summary of the evidence outlines the measured parameters and identifies the key study results and any study weaknesses.
Teleconsulting allows general practice veterinarians to use telehealth tools to communicate with veterinary specialists for their insights on patient care. This service provides a specialist's advice to help make an informed decision about a patient's condition—which is especially helpful when owners are unwilling or unable to seek a specialist referral for their pet due to the long wait times for a consultation.
8. Pathology Consultations
Many reference labs offer complementary pathology consultation services to provide personalized guidance about specific cases from board-certified veterinary pathologists. Typically, the consulting pathologist prepared the original biopsy or cytology report and is able to review the written diagnostics.
9. Artificial Intelligence in Veterinary Medicine
Artificial intelligence (AI) can provide clinical insights to facilitate your decision-making process by applying logic to patient-specific diagnostic results based on a variety of resources previously mentioned. The technology creates algorithms based on resources, such as textbooks, journals, and research, to present relevant, patient-specific advice and can play a role in disease recognition, sometimes even finding disease earlier than ever before. It can be used in and across many applications, including the following:
Chemistry: AI technology can help veterinarians determine a differential diagnosis, or their next steps in diagnosis or treatment, based on the patient's chemistry results. AI is scanning in the background for subtle patterns and can alert veterinarians when inconsistencies occur. For example, when a sick patient has patterns consistent with Addison's disease, like a stress leukogram or trends in analytes, the technology can prompt the veterinarian to investigate Addison's disease.
Complete blood count: Algorithms can facilitate the identification of common abnormal patterns and blood cell abnormalities in complete blood count results.
Urinalysis: Urinalysis analyzers use algorithmic software to help identify a urine sample's elements and can deliver clinical insights to help veterinarians make confident decisions.
Pathology: Pathology AI programs are taught to quantify, identify, measure, and collect information from microscopic images. They can interpret results accurately and aid in decision-making.
Radiology: Complex algorithms can quickly compare previous and current images, prioritize data, and streamline the interpretative process.
Oncology: AI technology can be used to assess cancer cells and determine which chemotherapy agent is likely to generate the best response.
Cardiology: Electrocardiogram algorithms can analyze ECG results and help detect arrhythmias.
Streamlined resources: AI programs are taught to follow consensus statements and expert guidelines, such as IRIS staging and CKD guidelines, which can streamline and simplify decision trees for complex cases.
As a veterinarian, you know that you have occasional doubts about your decisions. You likely want to feel confident that your choices are in your patient's best interest. These nine resources ensure you can access clinical decision support to help you provide the best possible care to each and every patient in your practice.