The Sceptical Vet: Eminence or Evidence? Finding the best way forward for the veterinary profession An open symposium Speaker Profiles and Programme 10.30 11.00 Coffee and Registration 11.00 Welcome from the Chairman Geoff Little MVB MRCVS Geoff qualified from Trinity College, Dublin in 1973. After a short spell in small animal practice and 5 years in mixed practice in Somerset, he returned to Stockport in 1979 to take up a partnership in Woodcroft Veterinary Group. Geoff retired from the partnership in April 2000 to pursue other interests within the profession, and then retired in December 2005 after 20 years as a Director of Centaur Services Ltd., one of the UK s largest veterinary wholesalers. Geoff is currently a veterinary business advisor for Anval Ltd., a UK advisory service on management and finance for the veterinary profession and Communications Training Associate with the Veterinary Defence Society, the UK s leading Veterinary Professional Indemnity Insurance Provider. Geoff s other roles have included being the director of MyVet Network in southern Ireland, a company that offers management advice to practices, director of the Veterinary Benevolent Fund, spoken on, and published, many articles on various aspects of Veterinary Practice Management both in the UK and abroad, including the following congresses, BSAVA, WSAVA, VPMA, BEVA, FECAVA and SPVS, Royal Canin VBF. Geoff is the co-author of the Handbook of Veterinary Communications Skills and of The BSAVA Manual of Small Animal Management & Development. Geoff is also a former president of the Society of Practising Veterinary Surgeons and Chairman of the Veterinary Angling Association. 30 October 2012 - Church House Conference Centre Westminster 1 P a g e
11.10 Session 1 Getting a handle on EVM: clarifying the basics and how and where it applies to veterinary practice Dr Sally Everitt BVSc PhD MRCVS Sally qualified from the University of Bristol in 1981. She has spent most of her working life in predominantly small animal practice but in 2011 joined BSAVA as Scientific Policy Officer. Having become interested in the concept of Evidence-based medicine through her work with the local Community Health Council she became interested in how these ideas could be applied in the veterinary field. Sally joined the SPVS Masters Group led by Bradley Viner looking at Clinical Audit in the veterinary profession and returned to university to study for a PhD looking at clinical decision making in veterinary practice at The University of Nottingham. Pam Mosedale BVetMed MRCVS Pam qualified from the Royal Veterinary College. She was a partner in a Veterinary Hospital for 17 years. She then took on the role of a Practice Standards inspector from the start of the BSAVA scheme, continuing her position under the RCVS when they took over the scheme in 2005. She was appointed as a Senior Inspector. Pam s helped practices with the clinical governance requirement in the RCVS Practice Standards Scheme. Pam also advised regular clinical discussion meetings, significant event reviews, communication of information learned at CPD meetings and on drawing up practice protocols and guidelines following team discussions. Now that there is a requirement for clinical governance to form part of all vets and RVNs professional activities is in the Code of Conduct, this has become even more relevant for the whole practice team. Pam is the joint editor of the BSAVA Guide to the Use of Veterinary Medicines. She has recently become an SQP assessor for AMTRA and is a Veterinary Investigator for RCVS. Pam also does some small animal locum work. 30 October 2012 - Church House Conference Centre Westminster 2 P a g e
11.40 Session 2: What has EBM done for the medicine field? Professor Khalid Khan, Professor of Women's Health and Clinical Epidemiology, Barts and The London School of Medicine and Dentistry Khalid Khan is Professor of Women's Health and Clinical Epidemiology at Barts and the London School of Medicine, Queen Mary University of London. His expertise is in clinical obstetrics-gynaecology, patient-oriented health research and medical education. He has published over 250 peer reviewed journal articles and authored 20 books and chapters. His research contribution is in systematic reviews (meta-analyses), multicentre primary prospective evaluations of treatments and tests, health technology assessment and evaluation of educational methods. He is an Editor of Evidence-based Medicine and BJOG: an International Journal of Obstetrics and Gynaecology. 12.10 Session 3: The veterinary landscape and perspective Dr Brennen McKenzie, President of Evidence Based Veterinary Medicine Association Dr. McKenzie is a 2001 graduate of the University of Pennsylvania, School of Veterinary Medicine and is a small animal general practitioner in private practice in California. He is currently president of the Evidence-Based Veterinary Medicine Association. Dr. McKenzie is also a member of the American Society of Veterinary Journalists, the author of the SkeptVet Blog, and a contributing author for the Science-Based Medicine Blog. He writes and speaks regularly on the subjects of evidence-based veterinary medicine and complementary and alternative medicine. The principles and methods of evidence-based veterinary medicine are powerful tools for improving patient care. Despite challenges and obstacles, there are many ongoing EVM projects around the world already contributing to the improvement of our knowledge and the welfare of our patients. With sufficient commitment and enthusiasm, we can further integrate EVM into the fabric of our profession, to the benefit of veterinarians and clients as well as patients. 1.15 2.00 Lunch 30 October 2012 - Church House Conference Centre Westminster 3 P a g e
.00 2.00 Session 4: Practical stories from the equine, small animal and farm animal sectors (including Panel Q+A) Dr Tim Mair BVSc PhD DEIM DipECEIM DESTS MRCVS Bell Equine Veterinary Clinic Kent Tim Mair graduated from the University of Bristol in 1980. Following a spell in general practice he returned to Bristol as a Horserace Betting Levy Board Research Training Scholar to undertake research into equine immunology and respiratory diseases. He obtained a PhD in 1986 and then stayed at Bristol as a Wellcome Trust Lecturer in equine medicine. He returned to equine practice in 1989, joining Bell Equine Veterinary Clinic in 1993 and becoming a partner in 1995. His main interests are equine internal medicine, soft tissue surgery and MRI. He has Diplomas from the RCVS in Equine Internal Medicine and Equine Soft Tissue Surgery, and is a founding Diplomate of the European College of Equine Internal Medicine. He became an Associate of the European College of Veterinary Diagnostic Imaging in 2011. He has been editor of Equine Veterinary Education since 1996. He has published over 150 articles in peerreviewed journals, as well as many non-peer-reviewed articles and book chapters. He has co-authored or co-edited a number of textbooks on equine medicine and surgery. Dr Aiden Foster PhD DipACVD MRCVS Animal Health and Veterinary Laboratories Agency (AHVLA) Dr Aiden Foster qualified from Bristol in 1987 after reading biology at the University of Nottingham. He worked in mixed general practice for several years where he developed an interest in dermatology. After studying for a PhD at the University of Bristol he completed a residency in veterinary dermatology and became a diplomate of the American College of Veterinary Dermatology. From 1997 to 2004 he was a lecturer then senior lecturer in veterinary dermatology at the University of Bristol. He served on the board of the European Society of Veterinary Dermatology for 10 years including as president. He is an honorary associate professor in veterinary dermatology at the Nottingham vet school. He has been with the AHVLA since 2004 and is 30 October 2012 - Church House Conference Centre Westminster 4 P a g e
based at the Shrewsbury regional laboratory. His particular interests include large animal dermatology, publishing and miscellaneous farmed species including camelids and deer. He has been editor-in-chief of the Wiley- Blackwell journal Veterinary Dermatology since 2006; he sits on the editorial boards of In Practice and the Journal of Feline Medicine and Surgery. He is a co-author of a Cochrane style analysis of RCTs in canine atopic dermatitis. Much is made of the high value evidence that resides within reviews of randomised controlled trials in human medicine. While it is relatively early days for veterinary reviews of RCTs, as more of them emerge veterinary clinicians and authors need to be aware of their roles and responsibilities when reading and preparing these large documents. Good quality reviews can inform new research and help vets and owners to make informed decisions about treatment choices for their pet. Dr Wendela Wapenaar MRCVS Clinical Lecturer in Farm Animal Medicine and Epidemiology, School of Veterinary Medicine and Science, University of Nottingham Wendela Wapenaar graduated as a farm animal veterinarian in Utrecht, The Netherlands. After a few months working in mixed practice in The Netherlands she moved to the Waikato in New Zealand to focus on dairy cattle work. After 2 years thoroughly enjoying New Zealand, a new challenge appeared and she moved to Prince Edward Island on the Canadian East Coast where she completed a residency in Ruminant Farm Animal Medicine. At the same university she completed her PhD in Veterinary Epidemiology. Her research topic was the epidemiology of Neospora caninum in dairy cattle and wildlife on Prince Edward Island. After almost 4 years in Canada, she moved to the UK, where she worked briefly in farm animal practice before starting at the School of Veterinary Medicine and Science in Nottingham as Clinical Lecturer in Farm Animal Medicine and Epidemiology. She is a Diplomate of the American Board of Veterinary Practitioners (Dairy Specialty) and now divides her time between research and teaching. Evidence based medicine and the effective transfer of knowledge gained from research to stakeholders within the farm animal sector are areas of interest, particularly when related to bovine reproduction, biosecurity and infectious disease control. 3.00 3.30 Tea / Coffee Break 30 October 2012 - Church House Conference Centre Westminster 5 P a g e
3.30 Session 5: Making a practical start - How practice vets can get involved Dr Rachel Dean BVMS PhD DSAM(fel) MRCVS Director, Centre for Evidence-based Veterinary Medicine Rachel graduated from the University of Glasgow in 1996 and spent 6 years in general practice before spending a year travelling the world and working in Australia. She was the Fort Dodge feline fellow at the Feline Centre at the University of Bristol from 2002-2005. Rachel holds the Royal College of Veterinary Surgeons diploma in Feline Medicine and is a recognised RCVS specialist in this field. She completed a PhD entitled Epidemiology of Feline Injection Site Sarcomas in the United Kingdom in 2010. Rachel is currently a Clinical Associate Professor in Feline Medicine at the School of Veterinary Medicine and Science at The University of Nottingham where she directs the Centre for Evidence-based Veterinary Medicine. She is studying for a Master in Evidence-based Healthcare at the University of Oxford. It is great to the RCVS Trust is highlighting the topic of Evidence-based Veterinary Medicine at their symposia. The staff at the Centre for Evidencebased Veterinary Medicine are very pleased to be involved with the day and hope it will highlight the fact that everyone in the profession has a role to play in finding practical ways to incorporate evidence-based principles into every day practice. Dr Douglas Grindlay BSc MA PhD MCLIP Veterinary Information Specialist, Centre for Evidence-based Veterinary Medicine Dr Douglas Grindlay has been Veterinary Information Specialist for the Centre for Evidencebased Veterinary Medicine at the University of Nottingham since April 2011. His role is to develop methods for effectively searching databases for the best evidence in veterinary medicine, and to contribute to methods of critical appraisal and systematic review for the veterinary profession. He also helps with the teaching of evidence-based medicine to final year vet students. Douglas previously ran the Skin Disorders Specialist Library website (later renamed NHS Evidence - skin disorders) for the National Library for Health 30 October 2012 - Church House Conference Centre Westminster 6 P a g e
and then NICE, while based in the Centre of Evidence Based Dermatology at the University of Nottingham. As part of this work Douglas produced a monthly evidence-based e-mail alert for NHS dermatology staff, carried out the searches for Annual Evidence Updates on major skin diseases, and compiled the skin disorders module of DUETs, the Database of Uncertainties about the Effects of Treatments. Douglas has an MA in Information and Library Studies from Loughborough University and a PhD in Agricultural Science from the University of Nottingham. He is a Chartered Member of CILIP, the Chartered Institute of Library and Information Professionals. Clare Boulton Librarian, RCVS Charitable Trust Library Clare Boulton has been Librarian at the RCVS Charitable Trust since April 2008. The Library provides access to evidence based resources for vets and veterinary nurses in practice. Resources include full text online journals and bibliographic databases including CAB Abstracts. As part of their work Library staff carry out literature searches either as part of a regular alerting service for subscribers or on request. They also offer workshops on how to carry out systematic searches for literature using a range of bibliographic databases. Clare has a Diploma in Library & Information Studies from Manchester Polytechnic and an Open University Diploma in Management Studies. She is a Chartered Member of CILIP, the Chartered Institute of Library and Information Professionals. 4.15 Debate: Future Policy Session Lead by Geoff Little MVB MRCVS This is an open debate with all speakers to identify key points as to how the profession can take EVM forward 4.45 Closing Remarks Geoff Little MVB MRCVS 5.00 6.15 Drinks reception 30 October 2012 - Church House Conference Centre Westminster 7 P a g e
Background The modern Evidence-based Medicine (EBM) approach to clinical care has been revolutionizing patient care in human medicine and policy for the last four decades, and has been thoroughly embraced by politicians and the wider public, even though animated debate about its usefulness is still occurring within the medical profession. The Cochrane Collaboration, a depositary of systematic reviews which support the foundations on which EBM has so far relied, has been growing in size, significance and number of published records. A similar veterinary database has been more challenging to set up, due to the particularities of veterinary medicine and also to the wide number of species that veterinary medicine oversees. The RCVS Charitable Trust, recognizing its mission in helping vets and vet nurses to provide the best possible care for animals, is supporting this symposium with a view to Objectives Provide a forum for debate where opinions on the clinical potential and the caveats of Evidence-based Veterinary Medicine (EVM) can be voiced Provide information on EVM, namely on the current status of its implementation in the veterinary profession and its future implications in veterinary practice and clinical governance To share and discuss lessons learned by the establishment of EVM principles in the human medicine field To encourage the setting of a forward-looking strategy to implement EVM practices across the profession To discuss EVM training needs for veterinary undergraduates and practitioners To help identify the important real-life clinical questions Outcomes Setting a forward looking strategy for the establishment of a collaboration to foster EVM in the UK Prioritising which actions to take in order to encourage a proactive approach in the profession towards the development of evidence-based resources Consider possible sources of support administrative and financial for EVM initiatives in the UK Establishment of forums and communication channels between those interested in EVM and clinical governance i.e. plans for continuing communication 30 October 2012 - Church House Conference Centre Westminster 8 P a g e