Harnessing the caseload and data generated by more than 1,000 practices offers so many opportunities for clinical studies. And the outcomes offer rewards for the doctors and teams who do the work—and for the practitioners and patients who benefit from new and cutting-edge information. It’s obviously a huge investment in our profession, and I think it’s so critical to step back from what we think we know and challenge our assumptions.
Across the entire network of VCA, we typically have 30 or more internal studies running. When one of our interns, specialty interns, residents or clinicians brings an idea to the table, they’re trying to address a knowledge gap they see. It’s key, when you’re undertaking something that requires so much effort, to tackle a question you really care about. Done right, these studies can bring new insights, challenge dogma, and uncover new and better ways to care for our patients.
For example, one of our recently published studies showed for the first time that dogs with GDV may not need to go directly from decompression to surgery—which is not what we were all taught. In fact, many of these patients aren’t the best anesthetic candidates. And the research showed that giving time for them to stabilize before surgery improved the outcomes. This was a retrospective study and requires further prospective studies to see if we were correct.
While the medical requirements should always come first, it’s also true that for a smaller private practice, immediate surgery poses a logistics problem. A smaller practice doesn’t have a boarded surgeon on call 24/7. Beyond better care for patients, staging decompression and surgery could also help practices by offering a bit more flexibility in the timing.
In another recent study, we learned that inducing vomiting in foreign body cases is much more successful that we have traditionally thought. Clearly this outpatient solution is far less expensive than scoping or surgery for the client. It’s less traumatic for the pet. And I hope the new research empowers private practitioners who don’t have an endoscope and who don’t want to or don’t like to do these surgeries.
I truly believe the Clinical Studies group at VCA is helping manifest a new paradigm around how clinical studies are performed. Access to more cases, more data, and more clinicians with questions leads to faster breakthroughs. And it’s exciting to help usher in that change.
Helping the next generation of specialists
Another rewarding aspect of heading up the Clinical Studies group at VCA is the opportunity to help residents publish and get boarded. At this moment, we’re supporting a large number of residents in completing studies and papers.
Recent data shows that 20 percent of residents don’t have everything they need to be boarded after three years of residency and three years post-residency. And for many of them, completing a study and publishing a paper is the crucial barrier. I truly, deeply enjoy helping them get a project done and achieve that last critical step.
The Clinical Studies group at VCA only launched in 2013, and it’s the first platform of its kind. So it’s a unique outlet for both trainees and sponsors for getting studies done. And beyond study development, with Dr. Barb Kitchell’s help we’ve been able to put more framework around journal clubs and teaching rounds for young doctors. We are also partnering with other MVH business units, like Dr. Teresa Lightfoot at Blue Pearl to take advantage of what each of us offers our trainees.
Often the questions residents’ studies tackle can be addressed with a retrospective approach, and we can use the vast stores of VCA data to learn something new. When we can’t address the clinical question retrospectively, we help residents design and execute a prospective study.
I think we’re at the tip of the iceberg when it comes to using data. There’s so much more to learn. And the studies we’ve done to date are relatively small. Someday I’d love to run multisite studies with thousands of patients. With that kind of statistical power we could answer questions that we can’t today. Imagine what could be possible with more consistent data input and more analysts who could help us dig even deeper into the diagnostics, treatments and outcomes information we have available across the VCA hospital network.
Making a difference
We’ve helped develop 20 peer-reviewed publications since 2013. That says to me that we’re making a mark—and the momentum seems to be increasing. We just had 2 publications accepted this week alone so the foundation we’re building is starting to bear fruit.
We’re being asked to collaborate more with academia, helping them get cases in the door or sharing data. We’re talking with key constituencies about how we set up collaborations and overcome common obstacles to collaboration. And the more we share, the more project opportunities come up.
Today we have six ongoing university / private practice collaborations underway. And we’re managing 25 sponsored studies with major industry players.
In private practice, we can get agreements in place faster for projects that can be pivotal in getting FDA approval. We see more cases, so we can get the data that’s needed faster. Ultimately that makes new options available to all veterinary patients.
And it’s the outcomes of research that let us grow as practitioners. New information is the only way we grow our options for therapeutics, diagnostics, and treatment algorithms. Without those outcomes, we’ll continue to practice at the same level we do today, and I think it’s safe to say no one in the veterinary community wants that.
We all want to improve the care we offer, and this is the path. Plus, good research begets new research. So we’re in the enviable position of asking questions that make all of our next questions smarter.