Recently, a number of products have been highlighted to me with grand claims as to what they can do to help horses. I have noticed a bit of a theme with regard to new devices (which could be systems, tech or tools) that suggests that they aid healing and promote performance. Sometimes I wonder if I am being overly sceptical because if these products do as they say then that’s amazing. However, it concerns me that they are praying on our vulnerabilities as caring horse owners to gain sales. Alternatively, they are legitimate and worth the money they cost but their sales pages are not clear. It’s common that these devices are fairly pricey, or you need to employ somebody to use them, and I often wonder if this money could be better spent elsewhere.
Each time I am pointed towards one of these devices, I take a look at the website and do a bit of searching around the area. There is a common theme of lack of citation to peer-reviewed evidence to support their use. I have been criticised in the past for being obsessed with evidence; however, I am a scientist and do my best to be an evidence-informed practitioner, so it’s only natural that I hold others to this standard. There’s also debate as to whether trials from inside laboratories or trials on humans can be directly translated to the use of horses. Personally, I think that there is more correlation between clinical trials conducted robustly on live humans when it comes to therapy devices compared to those in the lab as a whole. However, there are obvious differences, such as horses are hairy and have different layers of skin, which is relevant if you are trying to traverse this medium as part of your treatment.
I have been thinking more and more about why there is a lack of evidence in the use of these devices in horses. I actually had a really open discussion with one of the directors of a company selling a device, and it made me feel a little bit more lenient to the lack of evidence. Just a note it didn’t make me feel more comfortable about wild claims that were unsupported! The reason for the lack of evidence given to me was basically down to economics. Whether this is because of the cost to invest in a project to test their device, maybe to do with the fact that it is selling quite successfully without evidence or maybe it’s to do with the lack of time to conduct a decent study. A small sample-size pilot study is going to cost a company tens of thousands of pounds to fund. If a company invests that money and the results are not as promising as they hoped then that is going to be a huge conflict. Alternatively, companies can ask universities and colleges to run studies with students for them, perhaps with less financial Investments. However, from the other side of the fence, I know that might mean a lack of control in terms of the way a study is run, especially if it is strategic for students to pass their degree rather than the study outcome being the priority.
A critique of industry-funded research is bias, and actually, I would like to state that this is not such a hidden problem as perhaps the general public anticipates. You can very quickly find out from reading methodology if the study follows a robust plan such as blinded observers i.e those taking the measurements don’t know whether the horses had undergone the treatment or not. Another method to enhance study design is to have a control group which is either a completely separate group of horses or a crossover study with an adequate period between the treatment and the control phases to allow for washout of any treatment effects.
As a supervisor of research at university both at post-graduate and doctoral level I do have a bit of sympathy for some of these companies trying to gain evidence for their products.
However, and this is a big caveat to my sympathy, whilst some may claim a lack of evidence isn’t evidence of a lack of effect, what we are seeing is claims of effect standing out in far bigger flashy, bold print than the small print that says there isn’t any evidence in horses to show there is an effect.
Ideally I would like to see honesty and transparency in sales plus open discussions as to how we can support genuinely effective products and promote safety of those that either are not effective or negative.
