Caroline is a clinical vet who mainly treats cats and dogs. For her MSc in Evidence-Based Health Care project, she wanted to undertake research that would advance her learning about the process behind the evaluation of diagnostic tests within a veterinary context. For her dissertation, Caroline undertook a systematic review to determine the effectiveness of a new diagnostic test designed to detect chronic kidney disease in animals. The new diagnostic test measures symmetric dimethylarginine (SDMA), which is thought to identify chronic kidney disease (CKD) earlier than the more commonly used tests, which measure creatinine levels in the blood.
Caroline’s review of the research highlighted several issues with study design and emphasised the need for standardisation in research methods to better evaluate diagnostic tests. It also pointed out the potential risks of misdiagnosing healthy animals or diagnosing early-stage CKD where treatment benefits are unclear. As SDMA is already used in clinical practice, the review stresses the importance of properly assessing diagnostic tests before their widespread adoption, especially since veterinary diagnostic tests are not regulated.
Caroline explained, 'This research is significant because systematic reviews in veterinary medicine are rare, and this study identified critical flaws in studies evaluating SDMA. Better research is needed to determine the test's true accuracy and its applicability in real-world clinical settings.'
On receiving the award for her dissertation, Caroline expressed gratitude to her supervisor, Dr Annette Plüddemann, who supported her during the course of her study, as well Nia Roberts, and other members of staff at the Centre for Evidence-Based Medicine and beyond.
She said, 'Having never performed a systematic review before, I was a little apprehensive initially. However, my supervisor, Dr Annette Plüddemann, provided excellent support whenever I needed it throughout the whole process. I cannot thank her enough. I also received excellent support from Nia Roberts, an information specialist, and other members of the professional and academic staff at the Centre for Evidence-Based Medicine.
My colleagues at VetPartners also supported me. Special thanks to Dr Rachel Dean, who not only collaborated with me on this review but is also my Evidence-Based Veterinary Medicine mentor and my inspiration to join this MSc programme. Thanks also to Dr Kathryn Wareham, Dr Jenny Stavisky, Dr Christina Kuhl, and Dr Natalie Robinson for their expertise and support through this process.
Finally, I want to thank my partner, Helen, sincerely. I could not have done this without her unwavering patience and support.'
Asked for her final thoughts, Caroline commented:
'This process has been transformative for me. The knowledge and enthusiasm I gained from the remarkable teaching during this MSc has fundamentally changed how I look at the world.'
The Gillian Nicholls Prize is awarded annually to a Kellogg College student for the best performance in the MSc in Evidence-Based Health Care and is endowed by John Muddiman in memory of his late wife, Dr Gillian Nicholls, who undertook the MSc at Kellogg in 2002.