Investigating equine disease using multicentre electronic medical record analysis

Fund

Norman Hayward Fund

Grant

£103,580

Research Period

2014

Area of study

Equine

Description

Principal investigator:  John F Marshall

Summary

This study seeks to provide evidence to support and explain known relationships between laminitis and other diseases such as colic, endocrine and gastrointestinal conditions which have significant impact on horse health and welfare. It is anticipated that analysis of a multicentre electronic medical record database (EMR) will accurately determine the prevalence of significant diseases of horses, and lead to the discovery of novel, useful information to aid disease prevention and treatment. It will provide robust evidence on which to base future guidelines for horse owners and vets to reduce the impact of disease.

How this will be done

Using an EMR database to determine prevalence, risk factors, comorbidities, and impact on survival, the study will look at epidemiology of equine diseases, including laminitis and colic.
Whilst multicentre clinical research provides information that can be applied to improving the health and welfare of horses, the vast majority of equine clinical research involves a single centre or small number of cases, limiting the power of the study and the applicability of significant findings. Although multicentre studies provide larger, more representative samples of horses to be investigated, these are limited by the costs and organisational difficulties associated with data collection.
EMR systems document the diagnosis, treatment and outcome of horses in an accessible format. This growing database already contains the clinical records of approximately 500,000 horses, representing 39 equine clinics in the UK, USA and Canada. A preliminary search of the clinical records of 312,643 horses for colic and laminitis revealed 21,366 and 9,800 cases respectively. Using the large sample size of the EMR database, accurate information on the prevalence, diagnosis, treatment and outcome of equine diseases will be determined and the relationship between diseases, risk factors, and efficacy of treatment can also be determined. Evidence based strategies to improve equine health and welfare will be created using the results of this project.
The study should demonstrate the prevalence of major equine diseases and the effects of season, geographic location, and signalment on the veterinary-attended horse population and prevalence data will be used to identify those conditions with the greatest effect on equine morbidity.

Findings

In July 2016 John Marshall and his team at Glasgow published the paper "Prevalence, survival analysis and multimorbidity of chronic diseases in the general veterinarian-attended horse population of the UK" John and his team have discovered that, as UK horses are ageing, the number of them suffering from multiple long-term diseases is going up also. This mirrors the concerns in the human medical field surrounding how best to deal with an older population with more complex medical needs.  Identifying the significant trend towards an ageing horse population has never previously been analysed with this level of certainty.
In human medicine, researchers have had access to huge databases of patient information for decades, enabling them to uncover important health trends that would not have been possible with smaller data sets. This study represents the first large-scale analysis of horse health in the UK, having amalgamated thousands of records of episodes of care into a single 'big-data' resource.  This is the first study published using these data, and the methods used to analyse horse lifespan have never before been applied to animal data.  The combination of this new data resource and their cutting-edge epidemiology methods mean that they have produced UK horse health and longevity statistics of unparalleled accuracy.