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MULT500-0707: Clinical Applications of Evidence-Based Medicine

Richard Evans, Ph.D
Wanda Gordon-Evans, DVM, DACVS

July 3 - August 7, 2007
Interactive sessions: Tuesday evenings: July 3, 10, 17, 24, and 31; 9:30 - 11:30 pm ET (USA)

The goal of this course is to provide participants with the tools to use evidence-based medicine as part of professional practice. Unlike our human medical counterparts, the veterinary profession does not have large volumes of summarized research to support many therapies, prognoses, etiologies, and diagnoses. This means that the burden is on veterinary practitioners to treat patients based on their practice experience combined with an understanding of available evidence from research. However, not all research has the same weight. This course will describe how to glean and evaluate information from research manuscripts.

The course will have five two-hour sections corresponding to each week of the five-week course. The course should be a lively discussion in the framework of real examples.

Course Outline:

Week 1 (7/3):
The first section will be an introduction to the concepts, and a brief history of evidence-based medicine. The idea is to put EBM in the perspective of veterinary medicine and lay the groundwork for the subsequent sections. We will discuss levels of evidence, study design, steps to practicing EBM, and EBM for therapy, diagnosis, prognosis and etiology.

Week 2 (7/10):
Observational studies, especially retrospective studies, play a large role in providing evidence for therapeutic efficacy in veterinary medicine. In the second week we will discuss the pros and cons of observational studies and apply those ideas to the paper by Conzemius et al. "Effect of surgical technique on limb function after surgery for rupture of the cranial cruciate ligament in dogs" (J Am Vet Med Assoc. 2005 Jan 15;226(2):232-6). That paper will be assigned as reading after the first section.

Week 3 (7/17):
Randomized controlled trials are generally considered to have a high level of evidence, above that of observational studies. In the third week we'll discuss the pros and cons of randomized controlled trials and discuss the paper by Romans et al. "Effect of postoperative analgesic protocol on limb function following onychectomy in cats" (J Am Vet Med Assoc. 2005 Jul 1; 227(1):89-93).

Week 4 (7/24):
In the fourth week we'll put together the information we have learned in the previous weeks and have a discussion of formal approaches to ranking studies by their evidentiary value. We will formally score several papers, including the aforementioned papers.

Week 5 (7/31):
The fifth week will review the previous sections and also cover concepts behind combining different studies i.e. a meta-analysis or systematic review. We will read Aragon CL, Budsberg SC "Applications of evidence-based medicine: cranial cruciate ligament injury repair in the dog" (Vet Surg. 2005 Mar-Apr;34(2):93-8) and Aragon CL, Hofmeister EH, Budsberg SC, "Systematic review of clinical trials of treatments for osteoarthritis in dogs" (J Am Vet Med Assoc. 2007 Feb 15;230(4):514-21).

Copies or .pdfs of the required articles used in this course will be provided.

Discussions will begin on the start date of the course and will continue for 7 days following the last real time session.


Member/$175, Non-Member/$266 by June 19, 2007;
Member/$194, Non-Member/$296 after June 19, 2007

Required Textbook: None

Recommended Textbooks:

Handbook of Evidence-Based Veterinary Medicine - Cockcroft, Holmes; Blackwell Publishing Limited - 2003
Available in the VIN bookstore:
Be sure to log in to receive your member discount.

How to Read a Paper: The Basics of Evidence-Based Medicine, 3rd edition - Greenhalgh, Blackwell Publishing Professional - 2006
May be available from online retailers.

Evidence-Based Medicine, How to Practice and Teach EBM, 3rd edition - Straus, Richardson, Glasziou, Haynes; Elsevier Health - 2005
Available in the VIN bookstore:
Be sure to log in to receive your member discount.

For More Information on VIN's Upcoming CE Courses, check out

"This course has been submitted (but not yet approved) for 10 hours of continuing education credit in jurisdictions which recognize AAVSB RACE approval; however participants should be aware that some boards have limitations on the number of hours accepted in certain categories and/or restrictions on certain methods of delivery of continuing education. Call VIN at 1-800-700-4636 for further information."

COURSE WITHDRAWAL AND REFUND POLICY: Withdrawal prior to the listed start date of a course entitles the registrant to a complete refund or a credit toward a future VIN CE course, whichever is preferred. Withdrawal within 1 week after the listed start date (i.e. including no more than one real-time session) entitles the registrant to a credit toward any future VIN CE course. (Does not apply to courses with only one real-time session.) After the first real-time session, a registrant may withdraw due to special circumstances and receive prorated credit towards a future VIN course. These requests will be handled on an individual basis. The amount of the prorated credit will be determined based on 65% of the time remaining in the course at the time of withdrawal. It is not possible to withdraw retroactively.

Note: To ensure rapid handling of your request for withdrawal, we recommend that you call the VIN office at 1-800-700-INFO.

Debbie Friedler
Continual Education Division
Veterinary Information Network


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