Clinical evidence and recommendations: how do we get one from the other?

This presentation will attempt to address the following questions, either explicitly or implicitly:
• Why do we need evidence of effectiveness of our clinical actions (assessment of clinical signs, diagnostic tests, interventions, prognostication)?
• What are the levels of evidence and how good are they?
• How does one translate evidence into a recommendation or decision?
• What factors contribute to the weighting of evidence?
• Does weak evidence allow us to make a strong recommendation?
• Does strong evidence not always allow us to make a strong recommendation?
• How do I use this in practice?

The approach of using evidence to guide clinical decision making has been formalised in the last two decades in human medicine and is gaining traction in veterinary practice. As veterinary clinicians we have ethical and legal obligations to use methods and practices that are most likely to provide the ‘best’ outcomes for the animals we treat and their owners.
A traditional approach to deciding on the ‘best’ treatments, diagnostic tests or methods, and preventative measures has been to identify the highest quality evidence of effectiveness and to adopt the approach with strongest evidence of efficacy. The Cochrane collaboration and the Cochrane reviews exemplify and lead this approach in human medicine (http://www.cochrane. org/cochrane-reviews).  […]