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Bayesian analysis of a mastitis control plan to investigate the influence of veterinary prior beliefs on clinical interpretation

Green, Martin J.; Browne, William J.; Green, L.E.; Bradley, Andrew J.; Leach, K.A.; Breen, J.E.; Medley, Graham F.

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Authors

Martin J. Green

William J. Browne

L.E. Green

K.A. Leach

JAMES BREEN JAMES.BREEN@NOTTINGHAM.AC.UK
Clinical Associate Professor

Graham F. Medley



Abstract

The fundamental objective for health research is to determine whether changes should be made to clinical decisions. Decisions made by veterinary surgeons in the light of new research evidence are known to be influenced by their prior beliefs, especially their initial opinions about the plausibility of possible results. In this paper, clinical trial results for a bovine mastitis control plan were evaluated within a Bayesian context, to incorporate a community of prior distributions that represented a
spectrum of clinical prior beliefs. The aim was to quantify the effect of veterinary surgeons’ initial viewpoints on the interpretation of the trial results.

A Bayesian analysis was conducted using Markov chain Monte Carlo procedures. Stochastic models included a financial cost attributed to a change in clinical mastitis following implementation of the control plan. Prior distributions were incorporated that covered a realistic range of possible clinical viewpoints, including scepticism, enthusiasm and uncertainty. Posterior distributions revealed
important differences in the financial gain that clinicians with different starting viewpoints would anticipate from the mastitis control plan, given the actual research results. For example, a severe sceptic would ascribe a probability of 0.50 for a return of <£5 per cow in an average herd that implemented the plan, whereas an enthusiast would ascribe this probability for a return of >£20 per cow. Simulations using increased trial sizes indicated that if the original study was four times as
large, an initial sceptic would be more convinced about the efficacy of the control plan but would still anticipate less financial return than an initial enthusiast would anticipate after the original study. In conclusion, it is possible to estimate how clinicians’ prior beliefs influence their interpretation of research evidence. Further research on the extent to which different interpretations of evidence result in changes to clinical practice would be worthwhile.

Citation

Green, M. J., Browne, W. J., Green, L., Bradley, A. J., Leach, K., Breen, J., & Medley, G. F. (2009). Bayesian analysis of a mastitis control plan to investigate the influence of veterinary prior beliefs on clinical interpretation. Preventive Veterinary Medicine, 91(2-4), https://doi.org/10.1016/j.prevetmed.2009.05.029

Journal Article Type Article
Publication Date Jan 1, 2009
Deposit Date Apr 22, 2010
Publicly Available Date Apr 22, 2010
Journal Preventive Veterinary Medicine
Print ISSN 0167-5877
Electronic ISSN 1873-1716
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 91
Issue 2-4
DOI https://doi.org/10.1016/j.prevetmed.2009.05.029
Keywords Prior distribution, Clinical decision making, Bayesian analysis
Mastitis
Public URL https://nottingham-repository.worktribe.com/output/1014454
Publisher URL http://dx.doi.org/10.1016/j.prevetmed.2009.05.029
Related Public URLs http://www.elsevier.com/locate/prevetmed

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