More data won’t improve dog health – “Best of Health” article September 2020
At the end of the 4th International Dog Health Workshop, Dr Dan O’Neill said something along the lines of; “This is no longer about the dogs, it’s about the people”. Readers of this column will probably be tired of me getting on my Human Behaviour Change hobby-horse but that’s what Dan was alluding to; unless people change their behaviour, dog health won’t be improved.
The point I want to make about data is that it’s necessary but not sufficient. I suspect that presenting data to owners, breeders and judges might persuade 5-10% of them to do something different. Presenting data just doesn’t motivate many people to change their behaviour. Why is that?
Fear of Maths
Many breeds are overwhelmed by data from research papers, surveys and insurance companies, some of which gets analysed and turned into reports, but all too often breed clubs and breeders simply don’t have the skills to get real insight from the data.
Perhaps some people are “scared of maths”; others may not have the time and yet others may not see data analysis and interpretation as important for breed health improvement. Plus, some people think that “numbers speak for themselves” and don’t bother to present data in a way that might be helpful to others..
Add to that the manipulation of data by the media and the political spin put on “official statistics” and it’s no wonder that health data can get a bad press.
Breed Health Coordinators, in particular, are grappling with ever more complex data to understand how to improve their breed’s health. We have EBVs, COIs, Medians, Means, Odds Ratios and Confidence Limits, to name just a few terms that litter our breed health reading material. Who can we turn to to make sense of the numbers, provide insight and guidance?
People just don’t “get risk”
We have seen clearly over the past few months of the Covid19 pandemic that the majority of the public simply do not understand risk. At the time of writing, the median Infection Fatality Rate for England was 1.3%. That figure, however, masks a huge range of risks, depending on how old you are. Nearly 1 in 5 infected over the age of 75 had died. Under the age of 25, fewer than 50 infected people had died. People in that younger age group have more chance of being killed in a car accident than from Covid19.
When it comes to risk in canine health, some people struggle to understand risk-based screening programmes such as those available for hips and elbows. These are complex, multifactorial diseases which means, statistically it’s possible for a dog with a good score, still to have bad hips. Similarly, mating 2 dogs with good hips could still result in puppies with clinically poor hips, or dogs with poor hips could produce a puppy with no problem. The probabilities are that dogs with better grades will produce puppies with better grades and vice versa. Unfortunately, many breeders want “definitive” answers just like they might get with a DNA test that gives a Clear, Carrier or Affected result.
In the recently developed Respiratory Function Grading Scheme launched by the KC for brachycephalic breeds, advice for breeders is based on a risk matrix. This enables breeders to identify combinations of a screened sire and dam that would minimise the risk of producing puppies at risk of BOAS. There are no certainties about the puppies’ BOAS status but, by selecting from lower risk combinations, over time, breed health will be improved. This principle applies to all the clinical screening programmes for complex conditions.
Alternative facts
One of the other challenges to getting people to make the move from data to action is that there may well be “alternative facts” that can be used to disprove the overwhelming evidence that exists. All that is needed is one research paper that contains data that apparently contradicts the prevailing evidence. It’s then easy to cherrypick from that paper and persuade others that all the other evidence is flawed. I came across an example of this recently where evidence from a paper on surgery for a health condition was being used to contradict screening evidence. The two data sets simply weren’t comparable.
It’s tempting for those with scientific training to think that more data and evidence is the answer but, all too often, this just results in responses such as:
- My dogs have never suffered from that condition and I’ve had the breed for x decades
- It’s only research, what we need are facts
- It’s too soon to be making these decisions about breeding recommendations
- It’s only a problem with the commercial and back-street breeders; our dogs are better/healthier
For many pedigree health issues we already have plenty of data so if people aren’t acting on that data by now, providing more data is unlikely to persuade them to change their behaviour.
The “science” that is missing is that of Human Behaviour Change and an analysis of the lack of action from a behavioural change perspective would lead to very different conclusions than “give them more data/evidence”. We need to understand which of 3 types of reasons are preventing people from taking action to improve canine health.
Firstly, do they have the capability to change, including do they know why it is important and how to take action? Mostly, science has answered those questions, so a lack of action is less likely to be due to a capability gap.
Secondly, do they have the opportunity to take action? This includes, for example whether people have the time or money to participate in screening programmes. More importantly, this is also affected by whether they see their peers taking action; if nobody else is worried about low genetic diversity, why should I be? Social norms are powerful influencers, so finding ways to incentivise early adopters are vitally important.
Finally, do they have the motivation to act to improve breed health? Are they worried about any adverse consequences if they don’t act? Do they feel they want to or need to act and do they believe it would be a good thing to do? There is plenty of evidence that some health issues have become normalised, both by owners and vets. “It’s normal for a (breed name)” or “They all do that” are clues that an issue has been normalised.
In conclusion, we should stop trying to beat people into submission with more data and put more emphasis on finding answers to why people can’t or won’t change. To end on a slightly more humourous note, remember “A mathematician is a device for turning coffee into theorems.” [Paul Erdos].
So you want to be a Preservation Breeder? “Best of Health” article August 2020 in Our Dogs
So you want to be a Preservation Breeder?
Getting started with dog showing – new KC video
How to Get Started in Dog Showing, created by the Kennel Club.
Dog health needs a decision-making revolution: “Best of Health” July 2020
The recent furore about the Dutch government’s legislation affecting 12 brachycephalic breeds has seen yet more polarisation of views on both the definition of the problem and the potential solutions. In summary, the legislation uses a single measurement; the craniofacial ratio to specify which dogs can be bred from. Consequently, the Dutch KC has said it will no longer issue full pedigrees for puppies from those breeds that don’t meet the criterion for the length of nose to skull.
The resulting conversations from interested parties have, perhaps, generated more heat than light. Meanwhile, in a parallel Covid19 universe, we have been told regularly that our government is “following the science”. The question I want to consider in this month’s article is “how can evidence be used more effectively to support decision-making for breed health improvement?”.
We know, from years of observation, that there are many problems with the way evidence is used (or abused). Policy-makers in government often talk about evidence-based policy but the reality is that politicians often simply want to be seen to do something. The result is (usually) flawed policies and ineffective legislation, often with unanticipated consequences that actually make things worse. We also know that, in some breeds, people have cherry-picked data from research studies either to support their own case or to try to undermine other people’s arguments. Scientists value sound methodologies and are trained to develop well-designed studies and to look for robust evidence. Readers of their studies may not have that expertise and, to be fair, many researchers make little effort to make their results accessible for the lay reader.
Since we’re unlikely to develop more dog people with scientific training (in the short-term), we clearly need some other options to enable us all to have better, evidence-based, conversations about the problems and solutions.
Horizon scanning
Breed clubs often work reactively and get caught out when new studies are published or sensational stories appear in the media. In contrast, researchers regularly do “horizon scanning” to identify emerging issues. This might be as simple as a literature search for papers published in a particular area of interest. This probably isn’t a very practical option for breed clubs but it’s certainly something that Breed Health Coordinators do. In our BHC Facebook Group, we share newly published papers, regularly. These may cover breed-specific health conditions, general canine topics such as husbandry, behaviour and temperament, and genetics. The Kennel Club is also helping breeds to do this horizon scanning with the development of Breed Health and Conservation Plans, each of which includes an extensive literature survey of papers relevant to a breed.
Diverse perspectives
If decision-makers restrict themselves to their historical range of responses to a problem, they may overlook better options. We see this all too frequently in canine health projects; an assumption that yet more “education” or a “better website” will make a difference and change people’s behaviours. Campaigners can fall into this trap as well, with an assumption that “more legislation” or “bans” will solve a long-standing problem. We know from human behaviour change research that solutions based on compliance or punishment are far less likely to have the desired effect than incentive-based and positive-reinforcement options. We also know that successful behaviour change in areas like obesity and smoking often requires 10 or more, different interventions (single, simple interventions just don’t work).
So, in breed health improvement we do need to listen to a range of perspectives on the problem (and ways of solving the problem) because we know that diversity of thinking helps to generate new ideas for solutions. I probably shouldn’t mention Dominic Cummings but there is something to be said for his call for more “assorted weirdos” to be recruited! He was talking about the civil service; maybe we need the same on our breed club committees.
Ready access to data
It’s often hard for breed clubs and BHCs to get hold of research papers and published evidence in a timely way, to inform their decision-making. Finding and storing relevant papers is much easier these days with the various online tools that are available. You can set up a Google Scholar search for any papers containing keywords (e.g. “canine”, “genetic diversity”, “Dachshund”) and you will get regular notifications with links to the papers. Free tools such as Microsoft OneNote or Evernote are then great for storing, indexing and retrieving the papers of interest to you. Increasingly, BHCs are summarising key messages for their breed club members, buyers and owners in the form of infographics using free tools like Canva.
Not all “evidence” is created equal
I have written previously about the Trust Triangle which describes the different types of information you might come across and the levels of trust that can be associated with each. At the bottom of the Trust Triangle are non-experts with opinions. Facebook and social media are awash with these! Journalists and experts with a commercial interest also fall into this category. Next comes expert opinion; these are people who are widely acknowledged to be experts in their field. Many of them will know an awful lot about a very narrow field of science. They too come with their biases and personal agendas but, mostly, they will have years of experience and scientific data to back up their opinions. Moving up the Trust Triangle, we find primary scientific research. This is made public via “papers”, the best of which will be peer-reviewed, rigorous, well-reported and independent. At the pinnacle of trustworthy published scientific research are papers that present systematic reviews of multiple other studies. These publications dissect and critique a set of primary research papers in order to arrive at “the best evidence” to support a particular case (or to disprove it).
We all need to get better at understanding the quality of evidence presented to us, including issues such as bias, chance and risk. We have seen over the past few months that many people are completely hopeless at understanding risk. We see it in canine health screening too; people may not understand what a screening grade means in relation to a decision to breed or not, and the risk of producing “affected” puppies.
A final part of the revolution we need in breed health improvement is to make more use of collaborative group decision-making processes. Different groups lobbing data, opinions and solutions over the fence really isn’t conducive to transparency or consensus-reaching.
Returning to my opening comments about the brachycephalic issue, in 2016 I wrote one of these articles where I said “Overall, the good news is the problem is moving into solution mode” with the formation of the Brachycephalic Working Group. In 2020, we’ve got more than enough data; we still need more improvement.
“You can’t change the bricks, and together, you still have to build a wall.”
Chris Hadfield, Astronaut
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We need a bit less Sapp¡ and a lot more Zapp!
One of the best books on Leadership that I first read a long time ago is “Zapp! The Lightning of Empowerment”. I’ve even got a copy signed by the author, Bill Byham. Zapp! was named the number one business book of the 1990s in a survey of CEOs. I’ll save you the trouble of reading it (or Googling it) and cut to the main theme that runs through the book: every time you have a conversation with someone, they go away either Sapped or Zapped.
With Zapp! conversations, people go away feeling energised, enthused and motivated. Sapp¡ conversations do the opposite; they suck the energy out of people and make them feel there is little point in having a conversation with you, asking for your help, or making suggestions for new ways of doing things.
Zapp! is particularly relevant at the moment, as we begin to emerge from the Coronavirus lockdown. So many things are uncertain and that, inevitably, makes many people feel uncomfortable (at best) or incredibly anxious (at worst). There is a real danger that people fall into conversations about what we can’t do, rather than what we can do.
Crowdsourcing great ideas
In the various dog sport communities online, there are numerous conversations about how shows and events could get up and running again, when government advice permits, of course. One of the potentially good things about social media is that it is a great way to crowdsource lots of ideas in a short space of time. A friend in a non-show discipline is collating a list of ideas that her club can make use of so that they can re-start group training and competitions. One of the venues that we use for our Club Open Shows has recently contacted us to ask for our requirements and ideas to enable them to reopen for our events. They will get a far better set of ideas by asking all their users than by their management team trying to come up with the answers.
While there are plenty of great ideas, many of the online (and offline) conversations seem to be filled with Sapp¡ comments:
- “People wouldn’t be able to…”
- “Nobody would…”
- “It would be impossible to…”
- “The KC would never…”
When I am running leadership development programmes and innovation workshops, I often talk about the importance of “Yes, and…” responses. All too often, people respond with “Yes, but…” and the result is Sapp¡, not Zapp! I’m not saying there shouldn’t be disagreement or challenge, it’s just a matter of how that is said or written. It wouldn’t take much longer to say or write something like “Yes, and we would also need to work out how to…” or “Yes, and we could also…”, or “what if we ask the KC if we could…”, all of which leaves people feeling rather more positive and hopeful.
Constructive turbulence
As we move out of lockdown, we are entering a phase of “restore, rebuild and recreate” when we can set out new directions for our sport. Airline pilots refer to “constructive turbulence”, recognising that a bumpy tailwind can get you to your destination much faster. We have that opportunity following this pandemic. The easy option, however, is to follow the urge to return to what we previously knew as normal. As we get back into post-lockdown routines, the temptation will be to restore canine events and Breed Club activities to what existed before. For example, do we really need people travelling for hours to attend committee meetings that last only a couple of hours? Online meetings are currently the norm, both at work and with family and friends; the technology is free and (mostly) reliable, so why would we not apply this to our club meetings? People have been running webinars on all sorts of canine topics and even holding teach-ins on judging and breed standards. Do we still need to “go to” seminars?
Changing culture when there is a longstanding way of doing things is never easy, particularly if people are desperate to hang on to what they were familiar with. We can start the constructive turbulence process by recognising what has been achieved during the crisis period. The Kennel Club’s online dog show in April had over 39,000 entries and achieved a reach of nearly 2.5 million people across social media. As I write this, the KC is running its YKC online show and has recently created a YKC Instagram account to engage that generation of young dog enthusiasts. One of our Dachshund Breed Clubs is running an online 9-class fun dog show and raising funds for our health charity. The pandemic has shown how quickly new ideas can be implemented and how much fun and enthusiasm they can create.
Pushing an agenda to transform things is hard enough during the good times but doing it against the backdrop of a crisis like the Coronavirus pandemic is even more of a challenge. When leaders (Club chairmen, secretaries, and treasurers) are up to their necks in dealing with the impact of the current crisis, finding the time or energy to even talk about the future is a big ask. They should also bear in mind that worst-case scenarios very rarely materialise and should not be used as the basis for policy-making. It’s too easy to get anchored on the unlikely worst-case scenarios that result from Sapp¡ conversations.
Those whose livelihoods depend on keeping their customers engaged and happy are already innovating and adopting a “can do” approach. We are seeing that in the canine world and I hope the Zapp! conversations, online and offline, outweigh the Sapp¡ ones.
I’ll end with a quote from astronaut Chris Hadfield; “You can’t change the bricks, and together, you still have to build a wall”.
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