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Abstract

OBJECTIVE

To examine preferences of veterinary clinical pathologists, clinicians, and students for cytology report formats.

SAMPLE

24 clinical pathologists, 1,014 veterinarians, and 93 veterinary students who were members of the Veterinary Information Network.

METHODS

Members of the Veterinary Information Network responded to an online survey invitation, made available between July 11, 2023, and July 24, 2023. Respondents were randomly directed to 1 of 4 sets of cytology reports, each containing a traditional narrative format, narrative format with terms expressing a degree of confidence and associated numerical ranges, and template format with similar estimates of confidence. Respondents ranked the reports in order of preference and then provided comments about their top-ranked choice. Responses were analyzed mostly with descriptive statistics or comparisons of proportions.

RESULTS

14 of 24 clinical pathologists preferred the traditional narrative format, whereas 449 of 1,042 veterinary clinicians and veterinary students preferred the template format. Respondents (460/1,131) ranked the template format as most preferred, but the narrative format with terms expressing a degree of confidence ranked highest overall. Many respondents appeared to misunderstand the degree of confidence estimates being expressed numerically. Respondents choosing each format often stated that their preferred choice was “easiest to understand” and “most comprehensive.”

CLINICAL RELEVANCE

Given the preferences of veterinary clinicians and veterinary students for a template format, clinical pathologists should consider modifying the way they report evaluations of cytologic specimens. Template formats should help standardize reporting of cytologic specimens, thereby improving communication between clinical pathologists and clinicians. However, both clinicians and clinical pathologists need to better understand the purpose of terminology expressing degrees of confidence in such reports.

Open access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To examine the probability estimates for modifying terms used by clinical pathologists when interpreting cytologic samples and compare these to probability estimates assigned to these terms by clinicians, and to provide restricted, standardizing terms used in cytology reports.

SAMPLE

49 clinical pathologists and 466 Veterinary Information Network members responded to 2 similar surveys.

PROCEDURES

Online surveys were distributed to diplomates of the European College of Veterinary Clinical Pathologists and clinician members of the Veterinary Information Network, made available between March 17, 2022, through May 5, 2022. Respondents assigned a range of probabilities to each of 18 modifier terms used by clinical pathologists to denote probability associated with diagnoses; clinicians identified terms that would affect their treatment decisions in cases of canine lymphoma. Respondents then provided thoughts about restricting and standardizing modifying terms and assigning numeric estimates in reports.

RESULTS

49 clinical pathologists and 466 clinicians provided responses. For many terms, probability ranges agreed between the 2 groups. However, differences in estimated probability inferred by a term existed for at least 6 terms. Modifying terms could be restricted to 7 largely nonoverlapping terms that spanned the range of probabilities. Clinicians preferred having numeric estimates of probability, but clinical pathologists resisted providing such estimates in reports.

CLINICAL RELEVANCE

Reducing and standardizing the number of modifying terms to reflect specific probability ranges would reduce disagreement between the clinical pathologist’s intended probability range and the clinician’s interpretation of a modifying term. This could result in fewer errors in interpretation and better patient care.

Full access
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Objective

To determine whether keratan sulfate concentrations in plasma or synovial fluid from clinically normal horses were different from concentrations in horses with joint disease and whether concentrations varied with type of joint disease.

Design

Case-control study.

Animals

67 clinically normal horses, 10 clinically normal foals, and 160 horses with joint disease.

Procedure

ELISA was used to measure keratan sulfate concentrations.

Results

Mean plasma keratan sulfate concentration (mean ± SEM, 580 ± 124 ng/ml) in foals peaked at 10 weeks of age. Mean plasma keratan sulfate concentration in clinically normal horses was 200 ng/ml (95% confidence interval, 157 to 251 ng/ml). Horses with osteochondral (chip) fractures, other closed intraarticular fractures, inflammatory arthritis (synovitis), infectious arthritis, or osteochondrosis had significantly higher plasma keratan sulfate concentrations than did clinically normal horses, but horses with osteoarthritis did not.

Breed, gender, and type of joint disease affected keratan sulfate concentration in synovial fluid. Standardbreds with chip fractures of the metacarpophalangeal/ metatarsophalangeal joints had significantly higher keratan sulfate concentrations in synovial fluid than did Thoroughbreds. Keratan sulfate concentrations in synovial fluid from osteoarthritic carpal joints were lower than concentrations in normal carpal joints and tarsocrural joints with inflammatory joint disease.

Clinical Implications

Keratan sulfate concentration alone was not a specific marker of joint disease but was affected by various joint diseases. (J Am Vet Med Assoc 1997;210:369–374

Free access
in Journal of the American Veterinary Medical Association