Conflict Between Direct Experience and Research-Based Evidence Is a Key Challenge to Evidence-Based Respiratory Medicine on British Racing Yards.
Authors: Kinnison Tierney, Cardwell Jacqueline M
Journal: Frontiers in veterinary science
Summary
Inflammatory airway disease (IAD) remains a poorly standardised diagnosis in British racing, despite the 2015 American College of Veterinary Internal Medicine consensus statement proposing standardised diagnostic criteria and the term 'mild-moderate equine asthma' (mEA). Using focus group interviews with 25 veterinarians across four English racing practices, Tierney and Cardwell conducted qualitative thematic analysis to understand why British practitioners have largely rejected this evidence-based framework in favour of their own diagnostic approaches. Three dominant themes emerged: the overriding pressure to serve the racing industry (particularly trainer expectations), widespread disregard for the consensus case definition citing concerns about applicability to British horses and impracticality of bronchoalveolar lavage sampling, and clinicians' self-identification as pragmatists relying on direct experience rather than standardised protocols. The findings reveal a significant gap between international evidence-based recommendations and on-the-ground practice, driven by genuine contextual concerns about diagnostic feasibility and perceived irrelevance of research conducted without deep understanding of British racing culture. For equine professionals seeking to improve respiratory diagnostics and outcomes in racehorses, this research highlights both the need for continued dialogue between researchers and practitioners, and the urgent value of developing evidence-based diagnostic methods that are genuinely practical and contextually appropriate within the British racing environment rather than imposed from external consensus.
Read the full abstract on PubMed
Practical Takeaways
- •If you work on British racing yards, understand that your veterinarians may use different diagnostic criteria for airway disease than international guidelines recommend—this reflects pragmatic adaptations to your industry's needs, not necessarily poor practice
- •BAL sampling, while research-endorsed, may not be practical or widely implemented in your yard; discuss alternative diagnostic approaches with your vet that balance evidence and feasibility
- •Building better communication between researchers and racing professionals could lead to diagnostic methods that are both evidence-based and workable in your environment
Key Findings
- •British racing veterinarians widely disregard the ACVIM consensus case definition for IAD/mEA due to perceived differences in etiology, lack of practicability (especially BAL sampling), and perceived lack of understanding of the British racing context
- •The requirement to serve the racing industry and trainer preferences are key drivers of clinical approaches, often overriding research-based evidence
- •Veterinarians prioritize direct clinical experience as the most valuable evidence for decision-making, creating a barrier to evidence-based medicine adoption
- •Lack of alignment with international consensus reflects a gap between research recommendations and practical, context-specific racing yard protocols