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- Author or Editor: David T. Galligan x
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Abstract
Objective—To evaluate the epidemiologic efficacy and economic efficiency of current and potential future control programs for paratuberculosis (Johne's disease) on midsize dairy herds in the United States.
Design—Stochastic dynamic computer simulation model.
Sample Population—Data on prices and other input variables collected from various sources were used to represent a population of midsize US dairy herds infected with paratuberculosis.
Procedure—The simulation model was modified to reflect management and production characteristics of midsize dairy herds in the United States. The model was validated by use of field data and expert opinion. Various control strategies then were simulated and compared on an epidemiologic basis and on the basis of economic efficiency.
Results—Test-and-cull strategies and vaccination against paratuberculosis were not able to decrease the mean prevalence of disease in the United States. Typically, only vaccination was economically attractive. Improved management strategies decreased the prevalence of paratuberculosis considerably and had high economic benefits.
Conclusions and Clinical Relevance—Analysis of results of this study suggests that test-and-cull strategies alone do not reduce the prevalence of paratuberculosis in cattle and are costly for producers to pursue. Vaccination did not reduce the prevalence but was economically attractive. Finally, improved calf-hygiene strategies were found to be critically important in every paratuberculosis control program and most were economically attractive programs for midsize US dairy farms with the disease. (J Am Vet Med Assoc 2003;223:1757–1763)
Abstract
Objective—To use decision and sensitivity analysis to examine the delivery of health care on US dairy farms as measured by correction of left displaced abomasum (LDA).
Sample Population—5 journal articles evaluating outcomes from veterinarian- or herd personnel-delivered correction of LDA via laparotomy or a roll-and-toggle procedure.
Design—Economic analysis.
Procedures—A decision tree was constructed on the basis of published outcome data for correction of LDAs performed by veterinarians and herd personnel. Sensitivity of the model to changing input assumptions was evaluated via an indifference curve and tornado graph.
Results—Decision tree analysis revealed that correction of an LDA provided by herd personnel had an expected economic advantage of $76, compared with correction provided by a veterinarian. Sensitivity of this analysis to variations in inputs indicated that changes of 2 input levels would shift the advantage to veterinarian-provided correction: a reduction (from 0.74 to 0.62) in the probability of success for correction provided by herd personnel or an increase (from 0.78 to 0.87) in the probability of success for correction provided by a veterinarian.
Conclusions and Clinical Relevance—In this model, LDA correction by herd personnel had a significant economic advantage, compared with veterinarian-provided correction. Continued absorption of traditional veterinary tasks by unlicensed herd personnel may threaten the veterinarian-client-patient relationship (VCPR), which could have profound economic and regulatory impacts. Food animal veterinarians need to evaluate their business model to ensure they continue to provide relevant, sustainable services to their clients within the context of a valid VCPR.
