Anecdotal or experimental: how does published safety evidence affect self-reported willingness of avian veterinarians to use certain drugs in clinical practice?

OBJECTIVE: Assessment of how avian veterinarians interpret the relative strength of published studies with different design to incorporate drugs into their clinical practice. METHODS: Veterinarian and final-year student members of the American Association of Zoo Veterinarians and the European Association of Zoo and Wildlife Veterinarians were electronically surveyed about willingness to use 2 different drugs, polysulfated glycosaminoglycan (PSGAG; Adequan) and voriconazole, in birds. The assessment was made before and after reading case series describing adverse drug events (ADE) and subsequent controlled experimental study (CES). RESULTS: After reading each ADE series, 45 of 58 respondents (77.6%) reported willingness to use voriconazole and 15 of 42 (35.7%) to use PSGAG. After reading subsequently published CES of each drug, 50 of 53 respondents (94.3%) reported willingness to use voriconazole and 29 of 42 (69.0%) to use PSGAG. A majority of respondents (40 of 53 [75.5%]) stated that CES was more impactful in forming their overall opinion of voriconazole, and 29 of 42 respondents (69.0%) stated the same for PSGAG. CONCLUSIONS: Veterinarians are more likely to be influenced by the results of CES presenting evidence of potential drug safety as compared to ADE case series when determining whether to use a drug in clinical avian practice. CLINICAL RELEVANCE: Practicing high-quality, evidence-based veterinary medicine is essential to the health of all animals. Published CES provides greater influence on practicing avian clinicians than ADE case series. Experimental studies represent higher tiers of evidence than case series and are needed to challenge or confirm dogmas within the field of zoological medicine.