EDITORIAL

Keywords: EVIDENCE-BASED VETERINARY MEDICINE; CONTEXTUALISED CARE

Evidence-based veterinary medicine and contextualised care

Peter Cockcroft, MA, MSc, MBA, Vet MB, DVM&DCHP, Dip ECBHM1*
Editor-in-Chief

1 School of Veterinary Medicine, University of Surrey, Guildford, GU2 7AL
* Corresponding author email: eic@veterinaryevidence.org

Vol 11, Issue 3 (2026)
Published: 06 Jul 2026
DOI: https://doi.org/10.18849/ve.v11i3.754

Abstract

The welfare and the quality of life of the patient are central to the practice of veterinary medicine. With this in mind there is a growing number of treatment options available and factors related to the patient, the owner/carer, the type of consultation, the profession, the practice, the wider society, and sustainability both environmental and financial that should be considered when making a decision about the management of a patient. The similar terms contextualised care and spectrum of care have been used to describe these considerations.

Decision making in the practice of contextualised care/spectrum of care, whichever options are under consideration, should be informed by the best current evidence from scientific research. The primary role of the Veterinary Evidence journal is to provide the scientific evidence from published research in a form that can be interpreted by veterinary professionals and which can used to inform their decision making.

Contextualised care and the spectrum of care

The welfare and the quality of life of the patient are central to the practice of veterinary medicine. Advances in technology, an increase in the range of diagnostic tests available, and the expansion of referral practice in the profession have focused attention on the range of different patient management options available and additional factors that need to be taken into consideration (Englar, 2023a, 2023b; Skipper et al., 2024; Fredesco, 2025). The terms contextualised care (Skipper et al., 2024) and spectrum of care (Brown et al., 2021; Fingland, 2021) have been used to describe these considerations.

Contextualised veterinary care takes into account the aims, knowledge, experiences, and circumstances of individual animal caregivers and veterinary professionals, acknowledging the wider contexts of each clinical encounter, to deliver the most appropriate welfare focused care for every animal (Skipper et al., 2024). Factors related to the patient, owner/carer, type of consultation, profession, wider society, and sustainability should be considered (RCVS Knowledge, 2025).

The spectrum of care similarly refers to the wide range of care options veterinarians can provide and tailoring the care options based on contextual factors, such as client goals, abilities, and resources, as well as patient, veterinarian, and practice factors, while considering available evidence (Englar, 2023a, 2023b). These factors have been described in detail (Englar, 2023a, 2023b).

The Veterinary Evidence journal has recently published the findings of a survey investigating barriers to the delivery of contextualised care in UK small animal veterinary practice (Everitt et al., 2026). In parallel, RCVS Knowledge has developed a roadmap which describes the support that is needed to implement contextualised care (RCVS Knowledge, 2025).

Role of the journal in supporting contextual care/spectrum of care

The primary purpose of the Veterinary Evidence journal is to publish Knowledge Summaries that critically appraise scientific research related to important clinical questions which have an impact on patient care. Critical appraisal enables the strength of evidence provided by a study to be defined and the validity of the reported outcomes to be established. This information supports the practice of evidence-based veterinary medicine (EBVM) by veterinarians and veterinary nurses, and facilitates the translation of research into clinical practice to enhance the quality of care provided to animals.

There are 5 steps described in the practice of EBVM (adapted from Sackett, 1997):

  1. Defining a clinically relevant question
  2. Searching for the best available evidence
  3. Critically appraising the evidence
  4. Applying the evidence
  5. Evaluating the performance

A Knowledge Summary performs steps 1, 2, and 3. The responsibility for step 4, applying the evidence in clinical decision-making, and step 5, evaluating the performance, rests with the veterinarian. The relationship between scientific evidence, evidence-based veterinary medicine and contextualised care/spectrum of care is shown in Fig. 1.

Figure 1. Venn diagram illustrating the relationship between scientific evidence, evidence-based veterinary medicine and contextualised care/spectrum of care.
Figure 1: Venn diagram illustrating the relationship between scientific evidence, evidence-based veterinary medicine and contextualised care/spectrum of care.

 

Decision making in the practice of contextualised care/spectrum of care, whichever options are under consideration, should be informed by the best current evidence from scientific research.

The role of the Veterinary Evidence journal is to provide the scientific evidence from published research in a form that can be interpreted by veterinary professionals and inform their decision making. Contextualised care and spectrum of care prompt us to consider what we know to be true and why, so that we actively re-examine evidence-based options, and the way we deliver those options to clients (Englar, 2023a).

ORCiD

Peter Cockcroft: https://orcid.org/0000-0003-0090-07060

References

  1. Brown, C.R., Garrett, L.D., Gilles, W.K., Houlihan, K.E., McCobb, E., Pailler, S., Putnam, H., Scarlett, J.L., Treglia, L., Watson, B. & Wietsma, H.T. (2021). Spectrum of care: more than treatment options. Journal of the American Veterinary Medical Association. 259(7), 712–717. DOI: https://doi.org/10.2460/javma.259.7.712
  2. Englar, R.E. (2023a). Recasting the gold standard – part I of II: delineating healthcare options across a continuum of care. Journal of Feline Medicine and Surgery. 25(12), 1098612X231209855. DOI: https://doi.org/10.1177/1098612X231209855
  3. Englar, R.E. (2023b). Recasting the gold standard – part II of II: communicating healthcare options along a continuum of care. Journal of Feline Medicine and Surgery. 25(12), 1098612X231215639. DOI: https://doi.org/10.1177/1098612X231215639
  4. Everitt, S., Taylor, A., Doorly, A., Cropley, K., Osterberg, A. & Mantell, K. (2026). Barriers to the delivery of contextualised care in UK small animal veterinary practice. Veterinary Evidence. 11(2), 1–19. DOI: https://doi.org/10.18849/ve.v11i2.752
  5. Fedesco, H.N., Brodsky, J.E., Warman, S.M. & Khosa, D.K. (2025). The American Association of Veterinary Medical Colleges Spectrum of Care Initiative: supporting spectrum of care preparation in veterinary education programs. Journal of the American Veterinary Medical Association. 263(S3), S85–S91. DOI: https://doi.org/10.2460/javma.25.05.0358
  6. Fingland, R.B., Stone, L.R., Read, E.K. & Moore, R.M. (2021). Preparing veterinary students for excellence in general practice: building confidence and competence by focusing on spectrum of care. Journal of the American Veterinary Medical Association. 259(5), 463–470. DOI: https://doi.org/10.2460/javma.259.5.463
  7. RCVS Knowledge. (2025). Contextualised care: a road map, [online]. Available at: https://s47944.pcdn.co/wp-content/uploads/RCVS-Knowledge-Contextualised-care-roadmap-November-2025.pdf [Accessed 01 June 2026].
  8. Sackett, D.L. (1997). Evidence-based medicine. Seminars in Perinatology. 21(1), 3–5. DOI: https://doi.org/10.1016/S0146-0005(97)80013-4
  9. Skipper, A., O’Neill, D., Serlin, R., Davidson, J., Elwood, C. & Gray, C. (2024). Contextualised care: faddish or foundational? Veterinary Record, 195(3), 117. DOI: https://doi.org/10.1002/vetr.4567

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Copyright (c) 2026 Peter Cockcroft

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