91°µÍø

Dates: October 2024 - ongoing

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Camilla Pegram, Dan O’Neill, David Brodbelt, Noel Kennedy, David Church

Background

Randomised controlled trials (RCTs) are typically considered the gold standard for determining causal treatment effects. However, RCTs are not always practical or ethical. To address this, causal inference techniques such as "target trial emulation" can estimate real-world treatment effects by analysing anonymised veterinary clinical records, applying principles of RCTs to real-world data analysis (Hernán and Robins, 2016).

In October 2024, Dr Camilla Pegram completed a PhD titled “VetCompass eClinical Trials (VETs) – Generating Interventional Evidence from Observational Data”. This PhD research, funded by Dogs Trust, demonstrated that target trial emulation can yield valid and impactful results in veterinary science. The methods were applied to VetCompass data on four conditions to provide real-world inference for some key interventions. The following papers have been published based on this work to date:

•  Pegram C., Diaz-Ordaz K., Brodbelt D. C., Chang Y., Tayler S., Allerton F., Prisk L., Church D. B. & O'Neill D. G. (2023) PLOS ONE
• Pegram C., Diaz-Ordaz K., Brodbelt, D. C., Chang Y.,  Frykfors von Hekkel A., Wu C., Church, D. B., O’Neill, D. G. (2024) Preventative Veterinary Medicine
•  (infographic) Pegram C., Diaz-Ordaz K., Brodbelt, D. C., Chang Y., Hall, J., Church, D. B., O’Neill, D. G. (2024) PLOS ONE

Building on this foundational research, the VetCompass Causal Inference Research Programme aims to expand these methods into other collaborative projects. Target trial emulation is particularly well-suited for evaluating treatment interventions and outcomes, making it a powerful tool for the veterinary industry while also benefiting researchers and other stakeholders assessing real-world effectiveness. By reducing reliance on RCTs, while providing actionable insights, target trial emulation offers a cost-effective and ethical alternative to advance evidence-based veterinary medicine.

References

HERNÁN, M. A. & ROBINS, J. M. 2016. Using big data to emulate a target trial when a randomized trial is not available. American journal of epidemiology, 183, 758-764.