Report of the Canadian Veterinary Medical Association Expert Panel on rbST

Prepared for Health Canada, November 1998

Table of Contents

Executive Summary

1. Mandate
2. Committee Process
   2.1 Selection of Panel
   2.2 Conflict of Interest Screening
   2.3 Operation of Panel
   2.3.1 Panel Meetings
   2.4 Materials provided by Health Canada
3. Review Process
   3.1 Considerations in Defining the Process
   3.2 The Need to Combine Data
   3.3 Qualitative Assessment and Subjective "Pooling"
   3.4 Pooling Data
   3.5 Meta-analysis
   3.5.1 Statistical Methods in Meta - Analysis
   3.5.2 Comparability of Studies and Generalizability of Results
   3.5.3 Heterogeneity of Results
   3.5.4 Study Quality
   3.5.5 Publication Bias
   3.5.6 Guidelines for Interpreting Meta - analysis Output
   3.6 Literature Review
   3.7 Data Extraction
   3.8 Complete List of Issues
   3.9 General Structure for Presenting Outcome Evaluations
4. Efficacy
   4.1 Milk Yield
   4.1.1 Meta-analysis
   4.1.2 Comments and Conclusions
   4.2 Percent Fat (Butterfat)
   4.2.2 Comments and Conclusions
   4.3 Percent Lactose
   4.3.1 Meta-analysis
   4.3.2 Comments and Conclusions
   4.4 Percent Protein
   4.4.1 Meta-analysis
   4.4.2 Comments and Conclusions
5. Nutritional Implications
   5.1 Dry Matter Intake (DMI)
   5.1.1 Meta-analysis
   5.1.2 Comments and Conclusions
6. Body Condition
   6.1 BCS > 200
   6.1.1 Meta-Analysis
   6.1.2 Comments and Conclusions - BCS>200
   6.2 Other Estimates of Body Condition
   6.3 Comments and Conclusions - Body Condition
   6.4 Ability to Control/Eliminate Detrimental Effects
7. Udder Health
   7.1 Clinical Mastitis Rate and Risk
   7.1.1 Meta-analysis
   7.1.2 Comments and Conclusions
   7.1.3 Are the Effects Direct or Indirect ?
   7.1.4 Expected Increase In Cases of Clinical Mastitis
   7.1.5 Antibiotic Residues
   7.1.6 Ability to Control/Eliminate Detrimental Effects
   7.1.7 Additional Information Required
   7.2 Subclinical Mastitis
   7.2.1 Meta-analysis
   7.2.2 Comments and Conclusions
   7.2.3 Ability to Control/Eliminate Detrimental Effects
   7.2.4 Additional Information Required
8. Reproduction
   8.1 Incidence of Cystic Ovaries
   8.1.1 Meta-analysis
   8.1.2 Comments and Conclusions
   8.2 Services per Conception (SPC)
   8.2.1 Meta-analysis
   8.2.2 Comments and Conclusions
   8.3 Days Open (DO)
   8.3.1 Meta - Analysis
   8.3.2 Comments and Conclusions
   8.4 Twinning (Multiple Births)
   8.4.1 Meta-Analysis
   8.4.2 Comments and Conclusions
   8.4.3 Additional Information Required
   8.5 Non-Pregnancy Risk
   8.5.1 Meta-analysis
   8.5.2 Comments and Conclusions
   8.6 Risk of Abortion
   8.6.1 Meta-analysis
   8.6.2 Comments and Conclusions
   8.6.3 Additional Information Required
   8.7 Gestational Length
   8.7.1 Meta-analysis
   8.7.2 Comments and Conclusions
   8.8 Retained Placenta
   8.9 Overall Assessment of Reproductive Effects
   8.10 Ability to Control/Eliminate Detrimental Effects
   8.11 Additional Information Required
9. Feet and Legs
   9.1 Meta-analysis
   9.2 Conclusions and Comments
   9.3 Are the Effects Direct or Indirect?
   9.4 Ability to Control/Eliminate Detrimental Effects
10. Other Health Concerns
    10.1 Injection Site Reactions
    10.2 Metabolic Diseases
11. Culling
    11.1 Meta-analysis
    11.2 Comments and Conclusions
12. Animal Welfare
13. Drug Interactions
14. Conclusions and Recommendations
    14.1 Efficacy
    14.1.1 Yield
    14.1.2 Composition
    14.2 Animal Safety
    14.2.1 Body Condition
    14.2.2 Mastitis
    14.2.3 Antibiotic Residues
    14.2.4 Reproductive Effects
    14.2.5 Lameness
    14.2.6 Other Health Effects
    14.2.7 Culling
    14.2.8 Animal Welfare
    14.3 Additional Information
15. References Cited in the Text

Appendices

• Appendix 1 - Composition of CVMA Expert Panel on rbST *
• Appendix 2 - Meta-analysis review paper *
• Appendix 3 - Statistical Methods used in Meta-analysis *
• Appendix 4 - List of "Relevant Articles"
• Appendix 5 - List of "Key"Articles
• Appendix 6 - Summary of Material Provided by Health Canada
• Appendix 7 - Cover Sheets for all "Key"Articles
• Appendix 8 - Data Extraction Guidelines
• (PDF Version - 59 K) Appendix 9 - Listing of Full Database
• Appendix 10 - Calculations of Cases of Mastitis
• Appendix 11 - Classification of Subcutaneous Injections by the Canadian Council of Animal Care *

* Published material not available in HTML format; for information contact Hank Schriel at [613] 957-3051.