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PloS one2021; 16(1); e0244784; doi: 10.1371/journal.pone.0244784

Equine pituitary pars intermedia dysfunction: Identifying research priorities for diagnosis, treatment and prognosis through a priority setting partnership.

Abstract: Pituitary pars intermedia dysfunction (PPID) is the most prevalent endocrine disorder of older equids. To date, key research areas likely to have the greatest impact on equine health have not been identified. In human medicine, public and patient involvement is widely used to inform research agendas. This study aimed to engage with veterinary surgeons and horse owners to identify evidence gaps ('uncertainties') and prioritise these into a list of the 10 most important PPID research questions. The James Lind Alliance (JLA) Priority Setting Partnership (PSP) Framework was adapted. Questions about the diagnosis, treatment and prognosis of PPID were gathered via an online survey targeting veterinary surgeons and horse owners with experience of PPID. Thematic analysis was used to form a longlist of collated indicative research questions (CIRQs), defined by the JLA as true 'evidence uncertainties' when not answered by a published, clinically relevant, up-to-date systematic review. In an interim prioritisation survey, questions were ranked by weighted scores creating a shortlist of 25 that were taken forward to the PSP workshop, where participants reached a consensus on the top 10. Useable responses containing ≥1 question were received from 524 respondents (92.6% owners, n = 485; 7.4% veterinary surgeons, n = 39). After screening for relevance, 1,260 individual questions were included in thematic analysis, resulting in 47 CIRQs. Interim prioritisation votes for the CIRQs were received from 360 respondents. The top 10 questions prioritised at the PSP workshop focused on long-term prognosis, diagnostic accuracy, efficacy of pergolide treatment, alternative treatment/management strategies and potential treatment options for poor responders to pergolide. The quantity of questions generated indicates an extensive number of uncertainties regarding the diagnosis, treatment and prognosis of PPID. The top 10 research questions will help to inform key areas for evidence synthesis and knowledge translation, and to direct future research into areas most important to end users involved in caring for and treating animals with PPID.
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Publication Date: 2021-01-04 PubMed ID: 33395695PubMed Central: PMC7781667DOI: 10.1371/journal.pone.0244784Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research study aimed to identify the top ten uncertain areas of research into the pituitary pars intermedia dysfunction (PPID), a common endocrine disorder in aged horses. The areas of uncertainty were identified through a survey involving veterinarians and horse owners who have experience with PPID. The highlighted areas could then be prioritized to help in future research.

Research Methodology

  • The framework used for this study was the James Lind Alliance (JLA) Priority Setting Partnership (PSP). This survey-based approach is designed to bring patient-centric viewpoints into consideration when setting a research agenda. The framework was adapted for use in a veterinary setting instead of its normal human medical setting.
  • Questions about diagnosing, treating, and predicting the course of PPID were collected through an online survey. The respondents of this survey were veterinary surgeons and horse owners who have experience dealing with PPID.
  • The responses were analyzed using a thematic approach and were formed into a long list of collated indicative research questions (CIRQs), which are defined by the JLA as true ‘evidence uncertainties’ when they cannot be answered by an existing, clinically relevant, up-to-date systematic review.
  • An interim prioritization survey was then carried out, with responses weighted according to their perceived importance. This resulted in a shortlist of 25 questions that were taken forward to a PSP workshop.
  • At this workshop, the respondents reached a consensus on the top ten questions that require further research.

Results and Implications

  • The survey received responses containing at least one question from 524 respondents, the vast majority of whom were horse owners. A total of 1,260 individual questions were submitted.
  • These questions were then analysed and grouped into 47 CIRQs. The interim prioritization survey received votes from 360 respondents.
  • At the PSP workshop, the top ten questions centred around long-term prognosis, diagnostic accuracy, efficacy of pergolide treatment (a common drug used to treat PPID), alternative treatment strategies and potential treatments for those horses that did not respond well to pergolide.
  • The large number of questions generated points to a great deal of uncertainty surrounding the diagnosis, treatment, and prognosis of PPID.
  • The top ten questions identified in this study will aid future research efforts into PPID by highlighting the areas that have the greatest potential impact on equine health. This should lead to better evidence synthesis and knowledge translation in the field, ultimately benefiting the animals affected by PPID and those involved in their care.

Cite This Article

APA
Tatum RC, McGowan CM, Dean RS, Ireland JL. (2021). Equine pituitary pars intermedia dysfunction: Identifying research priorities for diagnosis, treatment and prognosis through a priority setting partnership. PLoS One, 16(1), e0244784. https://doi.org/10.1371/journal.pone.0244784

Publication

PloS one
ISSN: 1932-6203
NlmUniqueID: 101285081
Country: United States
Language: English
Volume: 16
Issue: 1
Pages: e0244784
PII: e0244784

Researcher Affiliations

Tatum, Rebecca C
  • Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom.
  • Centre for Preventive Medicine, Animal Health Trust, Newmarket, Suffolk, United Kingdom.
McGowan, Cathy M
  • Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom.
Dean, Rachel S
  • Centre for Evidence-based Veterinary Medicine, University of Nottingham, Sutton Bonington, Leicestershire, United Kingdom.
Ireland, Joanne L
  • Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom.

MeSH Terms

  • Animals
  • Biomedical Research / trends
  • Consensus
  • Health Priorities / statistics & numerical data
  • Horse Diseases / diagnosis
  • Horse Diseases / physiopathology
  • Horses
  • Patient Participation
  • Pituitary Diseases / diagnosis
  • Pituitary Gland, Intermediate / metabolism
  • Pituitary Gland, Intermediate / physiopathology
  • Prognosis
  • Research / trends
  • Stakeholder Participation
  • Surveys and Questionnaires
  • Veterinarians

Conflict of Interest Statement

As a collaborator Boehringer Ingelheim Animal Health UK Limited part funded this study, however, their only involvement in the priority setting partnership was to help disseminate the initial questionnaire to relevant participants. Both JI and CM have previously received funding for other specific equine endocrinology research projects from Boehringer Ingelheim Animal Health. This does not alter our adherence to PLOS ONE policies on sharing data and materials. The authors have no financial or personal relationships with other people or organisations that could inappropriately influence or bias the content of the paper.

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Citations

This article has been cited 4 times.
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