The importance of research for Fear Free

All evidence is not equal

While clinical experience and patient assessment are essential in guiding veterinary decision making, both medical and behavioral care recommendations must be based on the best available scientific evidence. Ongoing research is also critical to ensure that treatment protocols and the counseling we provide are supported by evidence and advance the quality and efficacy of the care veterinarians provide.

At the highest (and narrowest) level of the pyramid of evidence are systematic reviews and meta-analyses of multiple randomized controlled studies. However, these are generally impractical in clinical veterinary behavioral medicine because of the lack of availability of sufficient randomized controlled trials. Yet randomization, blinding, and a control group are necessary to control for bias and to provide a level of evidence that supports and validates the practitioner’s therapeutic recommendations. Also high on the evidence pyramid are practice guidelines and consensus statements based on critical appraisal of the best and most relevant evidence, but these too are only as sound as the available evidence.

While at least one blinded randomized controlled trial would be a minimum standard on which to base decision making, much of the evidence available in the field of veterinary behavior is far less robust (middle of the pyramid), including case-controlled studies that look at outcomes and risk factors and cohort studies that compare populations that received the treatment and those that did not. At the lowest level of the evidence pyramid (which is also the broadest) is research extrapolated from other species, expert opinion, and case reports.

Veterinarians must recognize, understand, and evaluate the evidence to provide pet owners with guidance and treatment recommendations grounded in science. With new evidence-based research, the quality and level of care is improved by expanding the knowledge base, increasing the understanding of disease processes and mechanisms, and by validating, modifying, or enhancing the diagnostic, preventive care, skills, and treatment options veterinarians can provide.

To help achieve these objectives the Fear Free research portfolio focuses on two important needs:

1. To support through funding of awards and grants, new original evidence-based research that targets prevention, assessment, and alleviation of fear, anxiety, and stress during travel, at veterinary visits, and in the home
2. To review, collate, and categorize published and current scientific evidence to maintain a bibliography of publications and research that document the following:
   • The effects of fear, anxiety, and stress (FAS) on physical and emotional health on the pet, owner, and veterinary personnel and on the delivery of veterinary care
   • The scope of the problem
   • The effectiveness of behavioral methodologies and both pharmaceutical or natural therapeutics in preventing or alleviating fear, anxiety, and stress, including how outcomes can be effectively assessed (measured).

Our current database is brand new and we will be adding relevant studies on an ongoing basis. To help us maintain and further expand our library of evidence, as well as promote and publicize research in the field, we encourage submission of new evidence-based research, as well any recommendations for additional publications we might include in our bibliography.

Fear Free Related Research – Bibliography