Strength of evidence

 

This page highlights all of the Knowledge Summaries published in Veterinary Evidence by the strength of evidence found.

If no primary research literature is found following a search of the literature then that is an important finding. Particularly if the search is on an important and common question that can have a high impact on patient care. The value of finding a lack of evidence (little or no published literature) is often underestimated and overlooked; it is a key finding to drive further research and informs the current knowledge or lack thereof.

We are of the stance that a Knowledge Summary with no evidence or not enough evidence is still a valuable outcome that should be shared.

The aim of this list is to highlight the information needs and evidence gaps, currently found within veterinary literature, to both funders and researchers applying for funding.

Knowledge Summaries evaluate the strength of evidence provided by the identified papers. The clinical bottom line in a Knowledge Summary provides the reader with a qualified answer to the clinical question posed.

The strength of evidence (or the confidence in the outcomes) provided by a study can be deduced from the study type, as well as factors that increase (e.g. large sample size) or reduce (e.g. lack of blinding) the strength of evidence.

All Knowledge Summaries published within Veterinary Evidence have been categorised into the below four levels of collective evidence as outlined by the author within the clinical bottom line:

Strong evidence

Species

Title

Year

Level of evidence

Canine

In Bitches Diagnosed with Pyometra, is Medical Therapy Using Antibiosis Alone as Effective as Combining Ovariohysterectomy with Antibiosis in Reducing Morbidity and Mortality?

2016

Strong

Canine

Which is More Effective in Altering the Intra-Gastric pH in Dogs, Omeprazole or Ranitidine?

2016

Strong

Canine

Is the Use of Hypertonic Saline Effective in Reducing Intracranial Pressure After Traumatic Brain Injury in Dogs?

2017

Strong

Canine

In Dogs With Traumatic Elbow Luxation, Does Treatment Using Closed Reduction and Conservative Management Have a Better Prognosis Than Those Treated With Open Reduction and Surgery?

2017

Strong

Canine

Choosing Treatment for Dogs With Generalised Demodicosis – Isoxazolines or Imidacloprid and Moxidectin?

2019

Strong

Canine

The Use of Ultrasonography for Detection of Meniscal Damage in Dogs

2019

Strong

Canine

In dogs undergoing elective procedures is medetomidine superior to acepromazine when used as a premedication?

2020

Strong

Canine

In dogs with osteoarthritis, how effective is treatment with tramadol in providing analgesia?

2021

Strong

Equine

In an Adult Horse With Severe Asthma (Previously Recurrent Airway Obstruction) Does Using Inhaled Corticosteroids Result in an Equal Improvement in Clinical Signs When Compared to Systemic Corticosteroids?

2018

Strong

Production

Does Heat Stress Affect Immune Function in Dairy Cows?

2016

Strong

Production

Are Sand or Composted Bedding Cubicles Suitable Alternatives to Rubber Matting for Housing Dairy Cows?

2018

Strong

Production

Performance and Behavioural Effects of Separating Dairy Cows and Their Calves at Birth

2019

Strong

Production

Can vaccinating sheep reduce the occurrence of caseous lymphadenitis?

2020

Strong

Production

Age at first calving in dairy cows: which months do you aim for to maximise productivity?

2020

Strong

Small Animal

In Cats and Dogs Does Laparoscopic Ovariectomy Offer Advantages Over Open Ovariectomy for Postoperative Recovery?

2017

Strong

Small Animal

Is There Any Evidence to Support the Use of Garlic as a Wormer for Dogs and Cats in the UK?

2019

Strong

Small Animal

Comparison of 0.2 Mg/kg Vs. 1.0 Mg/kg of Oral Meloxicam for Safe and Effective Analgesia in Domestic Rabbits

2019

Strong

 

Moderate evidence

Species

Title

Year

Level of evidence

Canine

In Dogs With Chronic Enteropathies, Can Oral B12 Tablets Be Used to Treat Hypocobalaminaemia?

2019

Moderate

Canine

Does Pet Remedy reduce stress in dogs?

2019

Moderate

Canine

In canine acute diarrhoea with no identifiable cause, does daily oral probiotic improve the clinical outcomes?

2019

Moderate

Canine

In dogs does low level laser therapy reduce healing time?

2020

Moderate

Canine

Comparison of the safety of alfaxalone and propofol as anaesthetic induction agents in bitches undergoing c-section

2020

Moderate

Canine

In dogs with congestive heart failure, is torasemide superior to furosemide as a first line diuretic treatment?

2020

Moderate

Canine

In dogs undergoing anaesthesia do pre-anaesthetic gastroprotectants reduce gastro-oesophageal reflux?

2020

Moderate

Canine

The effect of pre-emptive incisional bupivacaine block on postoperative pain after coeliotomy in dogs

2021

Moderate

Canine

Diagnostic accuracy of cytology for canine osteosarcoma compared to histopathology

2021

Moderate

Canine

Does medical or surgical treatment for aortic stenosis improve outcome in dogs?

2021

Moderate

Canine

Trilostane monitoring in canine hyperadrenocorticism: can basal cortisol measurement replace the ACTH stimulation test?

2021

Moderate

Canine

Evaluating the reliability of computed tomography for the diagnosis of intervertebral disc extrusion in dogs

2021

Moderate

Canine

Among homeless individuals, does owning a pet improve their mental health?

2021

Moderate

Equine

Can changes in hoof wall temperature and digital pulse pressure be used to predict laminitis onset?

2019

Moderate

Equine

Continuous digital hypothermia in the prevention and treatment of acute equine laminitis

2020

Moderate

Equine

In horses undergoing volatile anaesthesia, does intraoperative alpha-2-agonist infusion improve recovery?

2021

Moderate

Equine

Can sedation be used for equine lameness investigation?

2021

Moderate

Feline

Which Antibacterial Agent Performs Best for the Treatment and Clearance of Chlamydophila Felis Infection in Cats?

2017

Moderate

Feline

In Cats Infected With Feline Herpesvirus Type-1 (FHV-1) Does Treatment With Famciclovir Result in a Reduction of Respiratory and Ocular Clinical Signs?

2017

Moderate

Feline

Cats that get stressed when visiting the veterinary practice: can gabapentin help improve their welfare?

2019

Moderate

Feline

An evaluation of the use of ronidazole for the treatment of Tritrichomonas foetus in cats

2019

Moderate

Feline

Thrombolytic Therapy in the Acute Period of Aortic Thromboembolism in Cats

2019

Moderate

Feline

Should we offer total hip replacement to feline patients?

2020

Moderate

Feline

Efficacy of EMLA™ cream for reducing pain associated with venepuncture in felines

2021

Moderate

Feline

Do papillomaviruses cause feline cutaneous squamous cell carcinoma?

2021

Moderate

Production

In newborn piglets does drying versus no intervention reduce the risk of mortality pre-weaning?

2019

Moderate

Production

Does UK licensed NSAID administration reduce signs of postoperative pain in calves castrated without local anaesthesia?

2021

Moderate

Production

Tail docking and castrating lambs: does the administration of local anaesthetic or meloxicam reduce the pain response exhibited?

2021

Moderate

 

Weak evidence

Species

Title

Year

Level of evidence

Canine

Is Robenacoxib Superior to Meloxicam in Improving Patient Comfort in Dogs Diagnosed With a Degenerative Joint Process?

2016

Weak

Canine

The Evidence Behind the Diagnostic Investigation of Canine Idiopathic Epilepsy

2016

Weak

Canine

The Evidence Behind the Diagnostic Investigation of Canine Idiopathic Epilepsy

2016

Weak

Canine

Is there enough evidence to recommend surgical treatment as opposed to conservative treatment for dogs affected by bicipital tenosynovitis?

2016

Weak

Canine

Are Old Dogs Who Undergo Total Hip Replacement More Predisposed to Perioperative Femoral Fractures than Young Dogs?

2016

Weak

Canine

Does Physical Therapy after a TPLO Lead to Improvement of the 1-Year Post-Operative Peak Vertical Force?

2016

Weak

Canine

Are Dogs That Eat Quickly More Likely to Develop a Gastric Dilatation (+/- Volvulus) Than Dogs That Eat Slowly?

2016

Weak

Canine

Are Dogs That Are Fed from a Raised Bowl at an Increased Risk of Gastric Dilation Volvulus Compared with Floor-Fed Dogs?

2017

Weak

Canine

Are Novel Allergen or Hydrolysed Diets an Effective Means of Reducing the Gastro-intestinal Signs in Dogs With Inflammatory Bowel Disease When Compared to Oral Prednisolone?

2017

Weak

Canine

Are Dogs Fed a Kibble-Based Diet More Likely to Experience an Episode of Gastric Dilatation Volvulus Than Dogs Fed an Alternative Diet?

2017

Weak

Canine

In Dogs With Pyothorax Does Medical Management Alone, Invasive Medical Management, or Surgical Management Result in Better Long-term Outcome?

2017

Weak

Canine

Is Alpha-casozepine Efficacious at Reducing Anxiety in Dogs?

2017

Weak

Canine

In Dogs With a European Adder Bite, Does the Use of Antivenom With Supportive Treatment Compared to Supportive Treatment Alone Improve Time to Recovery?

2017

Weak

Canine

Does Adding Transdermal Nitroglycerine to Other Therapies Used for Management of Left-sided Congestive Heart Failure in Dogs Speed the Resolution of Clinical Signs?

2017

Weak

Canine

In Dogs That Have Had Intussusception Does Enterοplication Prevent Recurrence?

2018

Weak

Canine

Do Palliative Steroids Prolong Survival in Dogs With Multicentric Lymphoma?

2018

Weak

Canine

Are Pressure Vests Beneficial at Reducing Stress in Anxious and Fearful Dogs?

2018

Weak

Canine

In Adult Dogs, Does Feeding a Raw Food Diet Increase the Risk of Urinary Calculi Formation Compared to Feeding a Complete Dry Kibble Diet?

2018

Weak

Canine

Which Sternotomy Closure Method (Orthopaedic Wire or Suture) Is Recommended in Large Breed Dogs Undergoing a Median Sternotomy?

2018

Weak

Canine

Can Cytosine Arabinoside With Prednisolone Treatment for Canine Meningoencephalitis of Unknown Origin Increase Survival Time Compared to Prednisolone Treatment Alone?

2018

Weak

Canine

In Dogs Bitten by the European Adder (Vipera Berus), Do Corticosteroids and Supportive Treatment Improve Clinical Outcome Compared to Supportive Treatment Alone?

2018

Weak

Canine

In Dogs Does Feeding Raw Dietary Treats Reduce or Prevent Periodontal Disease?

2018

Weak

Canine

Does the Use of Intratesticular Blocks in Dogs Undergoing Orchiectomies Serve as an Effective Adjunctive Analgesic?

2018

Weak

Canine

Is an Anchoring or Pocket Technique Best for Surgical Repair of Cherry Eye in Dogs?

2019

Weak

Canine

Tibial Diaphyseal Fracture Rates Following Tibial Tuberosity Advancement Rapid (TTAR) and Traditional Tibial Tuberosity Advancement (tTTA)

2019

Weak

Canine

Treatment Duration With Steroid Monotherapy in Dogs With Steroid Responsive Meningitis-Arteritis

2019

Weak

Canine

Outcome of Electrosurgery Versus Scalpel Blade for Intestinal Incisions in Dogs

2019

Weak

Canine

In canine cranial cruciate ligament rupture is outcome following TPLO improved compared with lateral suture?

2019

Weak

Canine

There is no superior treatment method for medial shoulder instability in dogs

2020

Weak

Canine

Healing of equine heel bulb lacerations: Evidence behind casting compared to bandaging alone

2020

Weak

Canine

In female dogs undergoing elective neutering is ovariectomy or ovariohysterectomy superior?

2020

Weak

Canine

Comparison of epidural morphine and buprenorphine for hindlimb orthopaedic surgery in dogs

2020

Weak

Canine

It is unclear what impact pheromonotherapy has on stress in dogs in shelter environments

2020

Weak

Canine

In dogs with metaldehyde intoxication, are benzodiazepines more effective than methocarbamol in relaxing muscles and reducing tremors?

2020

Weak

Canine

Developments in surgical fluid therapy rates in veterinary medicine

2020

Weak

Canine

In dogs diagnosed with osteoarthritis, is meloxicam superior to carprofen for reducing patient discomfort?

2020

Weak

Canine

In pregnant bitches, is elective caesarean section more effective than vaginal delivery at improving puppy survival?

2020

Weak

Canine

In Greyhounds with paw pad corns, is surgical excision more effective at resolving lameness than extirpation?

2020

Weak

Canine

Non-Steroidal Anti-inflammatories: Does carprofen or meloxicam have fewer gastrointestinal side effects?

2020

Weak

Canine

The incidence of uterine pathology in ovariectomised bitches

2020

Weak

Canine

Managing atopic dermatitis in dogs: are antihistamines as effective as glucocorticoids?

2020

Weak

Canine

Does the use of topical honey result in a faster rate of second intention wound healing in dogs?

2020

Weak

Canine

In bitches, is ovariectomy/ovariohysterectomy by laparoscopy less painful postoperatively than by midline open laparotomy?

2021

Weak

Canine

Does ranitidine administration improve gastrointestinal hypomotility in dogs?

2021

Weak

Canine

Do dogs with non-surgically managed cranial cruciate ligament disease have better outcomes with rehabilitation?

2021

Weak

Canine

Uncomplicated gallbladder mucoceles – is it better for prognosis to perform cholecystectomy or medically manage?

2021

Weak

Canine

Comparison of alfaxalone versus propofol as anaesthetic induction agents in increasing the rate of survival and vigour of neonates

2021

Weak

Canine

Does turkey tail as an adjuvant therapy improve the quality of life of canine lymphoma patients?

2021

Weak

Canine

Does occurrence of ventricular arrhythmia reduce the survival rate in dogs with gastric dilatation volvulus (GDV)?

2021

Weak

Canine

Can IDEXX Angio Detect™ accurately detect canine Angiostrongylosis?

2021

Weak

Canine

Can dog appeasing pheromone ameliorate stress behaviours associated with anxiety in mature domestic dogs?

2021

Weak

Canine

The use of metronidazole in adult dogs with acute onset, uncomplicated, diarrhoea

2021

Weak

Canine

Current evidence supporting simultaneous prophylactic gastropexy in canine patients undergoing complete splenectomy

2021

Weak

Canine

Mortality rate comparison of enterotomy and resection and anastomosis (enterectomy) in dogs with foreign-body obstructions

2021

Weak

Equine

No Evidence That Therapeutic Systemic Corticosteroid Administration is Associated With Laminitis in Adult Horses Without Underlying Endocrine or Severe Systemic Disease.

2016

Weak

Equine

Evidence Supporting Intralesional Stem Cell Therapy to Improve Equine Flexor Tendon Healing

2017

Weak

Equine

In Horses With Chronic Laminitis, Do Venograms Compared to Plain Radiographs Give Greater Diagnostic or Prognostic Information?

2017

Weak

Equine

In Adult Horses With Septic Peritonitis, Does Peritoneal Lavage Combined With Antibiotic Therapy Compared to Antibiotic Therapy Alone Improve Survival Rates?

2017

Weak

Equine

The Use of Antibiotics in Broodmares With Post-service Endometritis

2018

Weak

Equine

Tenoscopic Debridement or Surgical Repair for Longitudinal Tears of the Equine Deep Digital Flexor Tendon Within the Digital Flexor Tendon Sheath?

2018

Weak

Equine

Do Oral or Minimally Invasive Cheek Tooth Extraction Techniques Reduce the Incidence of Post-operative Complications in the Horse When Compared to Repulsion Methods?

2018

Weak

Equine

The Effects of Biannual Equine Influenza Vaccine on Performance in Adult Horses

2019

Weak

Equine

Comparing Rest Alone to Bandaging and Rest in Horses With Superficial Digital Flexor Tendinopathy

2019

Weak

Equine

Is removal of proximo-plantar osteochondral fragments necessary in young Thoroughbreds?

2019

Weak

Equine

Does intra-articular injection of antimicrobials alongside corticosteroids or other medications reduce the risk of synovial sepsis?

2019

Weak

Equine

There is no evidence that the addition of antimicrobials reduce the risk of sepsis after intra-articular corticosteroids in horses with arthritis

2020

Weak

Equine

Distal tarsal joints osteoarthritis: Evidence behind bisphosphonates and NSAIDs to improve lameness

2020

Weak

Equine

Are bisphosphonates a more effective treatment than intra-articular steroids in horses with distal hock osteoarthritis?

2020

Weak

Equine

In mares with placentitis does the duration of antibiotic treatment affect foal outcome?

2020

Weak

Equine

In horses with osteoarthritis, is mesenchymal stem cell therapy more effective at managing lameness than intra-articular corticosteroids?

2020

Weak

Equine

In horses with trigeminal-mediated headshaking, is neuromodulation with EquiPENS™ more effective than with electroacupuncture?

2021

Weak

Equine

Is inhaled immunotherapy more effective than environmental management when treating equine asthma?

2021

Weak

Equine

For horses undergoing general anaesthesia, are rope recoveries or free recoveries better?

2021

Weak

Equine

Cryotherapy of the distal limbs: an effective treatment for equine laminitis following onset of lameness?

2021

Weak

Feline

Are Adult Cats Fed on Wet Maintenance Diets Less at Risk of Developing Chronic Kidney Disease Compared to Adult Cats Fed on Dry Maintenance Diets?

2017

Weak

Feline

Is Topical or Systemic Antimicrobial Therapy More Effective for the Treatment of Feline Acne With Secondary Bacterial Infection?

2018

Weak

Feline

Does the Use of Intratesticular Blocks in Cats Undergoing Orchiectomies Serve as an Effective Adjunctive Analgesic?

2018

Weak

Feline

Percutaneous Drainage in the Management of Urethral Blockages in Cats

2018

Weak

Feline

Reluxation Rates Following Different Techniques for Open Stabilisation of Feline Coxofemoral Dislocations

2019

Weak

Feline

Can Iodine-restricted Diets Normalise Serum Total Thyroxine (TT4) and Subsequently Improve Clinical Signs in Cats With Hyperthyroidism?

2019

Weak

Feline

Should Levetiracetam or Imepitoin Be Used in Preference as Second-line Treatment in Pharmacoresistent Epileptic Cats?

2019

Weak

Feline

Is a cross-match necessary before a cat’s first blood transfusion?

2020

Weak

Feline

‘Don’t pee on that!’ Comparing environmental modification and medical management in cats with FIC

2021

Weak

Feline

Insulin choice in feline diabetes mellitus

2021

Weak

Feline

Are glucocorticoids or NSAIDs more effective in reducing idiopathic feline urinary tract disease signs than no treatment or placebo?

2021

Weak

Feline

Is soybean therapy better than ClinOleic for reducing recovery time in cats with permethrin toxicosis?

2021

Weak

Feline

Use of the feline interdigital semiochemical (FIS) to redirect unwanted scratching behaviour in cats

2021

Weak

General

Non-Clinical Benefits of Evidence-Based Veterinary Medicine

2016

Weak

General

In Small Animal Surgery Are Alcoholic Hand Rubs Superior to Scrubbing Brushes and Antimicrobial Soap at Reducing Bacterial Counts?

2016

Weak

General

Can I Hang? Ideal Time to Replace Isotonic Crystalloid Intravenous Fluids and Sets to Prevent Fluid Contamination and Blood Stream Infection: a Knowledge Summary

2016

Weak

General

When Preparing Veterinary Patients for Surgery Is the Friction (Back and Forth) Method of Scrubbing the Skin More Effective Than Concentric Circles at Reducing Bacterial Levels on the Skin?

2018

Weak

General

Reducing Veterinary Waste: Surgical Site Infection Risk and the Ecological Impact of Woven and Disposable Drapes

2019

Weak

General

An assessment of the impact of educational interventions on hand hygiene compliance

2020

Weak

Production

In Dairy Cows with Clinical Mastitis Do Systemic Antimicrobials in Addition to Intramammary Antimicrobials Improve Clinical Cure Rates Compared to Intramammary Antimicrobials Only?

2016

Weak

Production

Insufficient evidence intraperitoneal fluid is equivalent or superior to intravenous fluid therapy in dehydrated calves

2020

Weak

Small Animal

Does the Use of Lidocaine in Dogs and Cats Reduce Post-Operative Tracheitis?

2017

Weak

Small Animal

Choice of Suture Pattern for Linea Alba Closure

2017

Weak

Small Animal

In Solitary Rabbits, Does the Presence or Absence of a Mirror Affect Stress, Fear and Anxiety?

2019

Weak

Small Animal

Should doses exceeding 0.2 mg/kg of oral meloxicam be given to reduce surgical recovery time in rabbits and should twice daily administration be considered?

2021

Weak

Small Animal

In ferrets with hyperadrenocorticism, does use of deslorelin acetate implants compared to adrenalectomy result in a superior prognosis?

2021

Weak

 

Zero evidence

 

Strength of evidence provided by the study designs

Definition

Strong

High level of confidence that the estimate of the effect reported by the studies lies close to the true effect. 

Moderate

Moderate confidence that the estimate of effect reported by the studies lies close to the true effect. 

Weak

Limited confidence that the estimate of effect reported by the studies lies close to the true effect. Additional appropriate studies are required.

Zero

No studies available.

This page will be updated annually.