Ten key research questions around Cushing’s disease in horses have been identified in a British study involving owners and veterinarians.
They focused on long-term prognosis, diagnostic accuracy, the efficacy of pergolide treatment, alternative treatment/management strategies, and potential treatment options for poor responders to pergolide.
Cushing’s disease, more formally known as pituitary pars intermedia dysfunction (PPID), is the most prevalent endocrine disorder of older horses.
Researchers in the University of Liverpool study set out to engage with veterinary surgeons and horse owners to identify evidence gaps and prioritise these into a list of the 10 most important PPID research questions.
Rebecca Tatum and her colleagues, writing in the open-access journal PLOS ONE, described a process in which questions about the diagnosis, treatment and prognosis of PPID were gathered via an online survey targeting vets and horse owners with experience of the condition.
In all, 1260 questions were received from 524 respondents, 92.6% of whom were horse owners and 7.4% were vets.
These were reduced to a longlist of 47 collated indicative research questions not answered in published scientific literature.
Questions were ranked by weighted scores, creating a shortlist of 25 that were taken forward to a workshop, where vets and horse owners reached a consensus on the top 10.
The top 10 questions appear in the table below.
The study team said the quantity of questions generated indicated 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.”
Discussing their findings, the authors noted that the responses and questions posed by participating veterinary surgeons did not differ markedly from those posed by owners.
The final workshop, they said, allowed an open and thoughtful exchange of views between horse owners and veterinary surgeons.
“This enabled consensus to be developed and facilitated the identification of the top 10 research questions.”
They acknowledged that the questions may prove complex to answer in terms of study design, implementation, ethical concerns and financial limitations. “However, the breadth of each topic offers researchers the opportunity to develop future studies dependent on resources available.
“Although all questions are considered important, it may not be possible to fund or answer all of them.
“In addition to supporting the direction of future research, the top 10 questions identify specific issues that horse owners consider important within each topic, providing a valuable resource to inform targeted owner education.”
The study team comprised Tatum, Cathy McGowan and Joanne Ireland, all with the University of Liverpool; and Rachel Dean, with the University of Nottingham.
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