Making the move from data to improvement – my August 2016 “Best of Health” article

It’s beenBest of Health interesting following the information emerging from the various discussions on brachycephalic breeds. We’ve heard from vets calling for action to address the health issues, including via online petitions. The Kennel Club in Norway has set out its proposals for improvement and our own KC has convened a working group. Over in Pedigree Dogs Exposed land, there’s the CRUFFA campaign to discourage the use of images of flat-faced animals in advertising and the media. All this follows on from the RVC’s “Building better Brachycephalics” day in 2013.

If you’ve not seen them, it’s well worth heading to vet Pete Wedderburn’s Facebook page to watch the videos he live-streamed of the various (excellent) presentations made at the first meeting chaired by Steve Dean at Clarges Street. From comments in one of the videos, it appears that it came as a surprise to some attendees that the meeting was being live-streamed by Pete. The presentations made by the scientists clearly summarised the evidence for the breadth and scale of the health problems facing brachycephalic breeds, both at individual dog level and at population level. The evidence is indisputable and the work done by David Sargan and his colleagues at Cambridge University means there are now practical ways to measure and score the health impacts in individual dogs.

The focus of that first meeting was very much on data and “the science”, with less of a discussion of the factors that have (a) led breeders to produce health-compromised dogs or (b) caused such a massive increase in demand from the puppy-buying public. The demand issue is clearly an area of focus for the CRUFFA campaign.

There was a second meeting at the KC at the end of July, but I believe Pete wasn’t present, so there are no videos to watch. In addition to the scientists, these KC meetings have included Breed Health Coordinators such as Penny Rankine-Parsons (FBs) and Vicky Collins-Nattrass (Bulldogs), both of whom have been incredibly proactive in their breed health improvement work.

At the end of the first meeting, participants were asked to go away and draw up an A4 page of actions they felt could/should be taken. Apparently, they were asked not to put “change the Breed Standards” at the top of their lists. Pinning the blame, and focusing the actions, on the KC and show communities is far too narrow a perspective if we want to improve the health of these dogs. Overall, the good news is the brachycephalic problem is moving into solution mode.

Complicated or Complex?

What interests me is how this will be managed as a Change Programme. Doing the data analysis and the science may be complicated but there are some world-class people working on these aspects. However, making change happen is complex (rather than complicated) and, the knowledge and skills needed are totally different, particularly when it comes to changing buying behaviours in the wider population.

I deliberately used the words “complicated” and “complex”. It is important to understand the difference between “complicated” and “complex” situations. The complicated context calls for investigating several options where there may be multiple “right answers” and is the domain of subject matter experts, like the scientists working on brachycephalic health. One of the dangers is that innovative suggestions made by non-experts may be overlooked, or dismissed. The voices of the Breed Health Coordinators with their wealth of practical experience need to be heard. Another risk in complicated situations is “analysis paralysis”; the tendency to keep searching for the perfect set of data, or the perfect answer to a problem, which means that very little gets implemented. Decision-making in complicated situations can take lots of time and there’s always a trade-off between finding the “right answer” and simply making a decision in order to make some progress.

When it comes to implementing changes to improve brachycephalics, the situation is complex; there are no right answers. We already know from the science that the issues are not even the same in the different brachycephalic breeds. David Sargan was reported on the BBC in response to the paper published on Bulldog genetic diversity and he said “we now have pretty strong evidence that there are still multiple genetic variations between those that do and those that don’t suffer from the disease (BOAS). But, we do not know whether this is also true for other aspects of conformation and appearance related diseases.”

There are bound to be many competing ideas and what will work is likely to emerge from a range of innovative approaches. There are lots of different people who have to be engaged and whose behaviours have to change. We shouldn’t underestimate the challenge of reaching and influencing the large number of breeders outside the KC/Breed Club communities. There will be a need to encourage dissent and diversity of ideas, as well as a willingness to “just try stuff” and see what works. That’s probably going to be uncomfortable for some people, particularly if they prefer working in a world of “right answers”, predictability and hierarchical decision-making.

We need to stop reacting to individual reports and look at the whole picture. Somebody needs to be joining the dots, otherwise we just add to the doom and gloom feeding frenzy in the press.

Agile or Big Bang?

What is the strategy for change with brachycephalics? Will it be exploratory and agile, or will it be a “big bang” launch and roll-out of a “package” of solutions? If it’s the former, then it would be perfectly valid to implement a change to a Breed Standard and see what happens. It’s a simple decision to make and it will either make an impact on its own, or not!

The trouble with that one, simple decision, is that we know it will not be enough on its own. But, it could be implemented quickly and could be seen as part of what Dave Brailsford, the Team GB Cycling Director, called the concept of marginal gains. Brailsford believed that if it was possible to make a 1% improvement in a whole host of areas, the cumulative gains would end up being hugely significant. The successes of Team GB and later Team Sky clearly demonstrate the power of this approach.

There were already a few ideas being touted around on social media before the second meeting hosted by the KC. Each of these has a cost and a potential value (or impact), so their relative merits need to be evaluated. The speed with which they could be implemented also needs to be agreed. Here’s my view of what a cost-value map might look like for a few of the ideas I read about. Green ideas could probably be implemented quickly, Orange ones would take longer and Red ones would be much longer-term.

Building Better Brachycephalics 2

The good thing is that the ideas cover both the supply side and demand side of the problem. They also contain a mixture of small changes and big changes. “Change the Breed Standards” is a small change, whereas “Educate the public” is a big change. The latter cannot actually be implemented; it needs to be broken down into doable activities like “run a series of campaigns on TV”, “get celebrity owners to talk about their pets’ health issues”, or “produce posters to display in all vets’ waiting rooms”.

What struck me about the lists of ideas I saw was just how few ideas there were. That’s possibly just a reflection of the mix of big and small ideas. Linus Pauling, the American scientist said “the best way to have a good idea, is to have lots of them”. There are certainly plenty of keyboard warriors willing to share their views online; how about building that into the solution-generation stage of the Brachycephalic improvement programme? Maybe there’s an opportunity to “crowdsource” more ideas. Just a thought!

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20 years of the Sunsong website – down memory lane

2016 marks the 20th anniversary of my Sunsong website. Back in 1996, the internet was a relatively lonely place and so much more text-based than we see today. I used a dial-up modem at 9.6 kbps and if I was using the internet, we couldn’t use our home phone at the same time. Amazingly, by the end of 1996, the site had received over 44,000 visits.

Initially, I used the Compuserve service, then migrated to one hosted by Software Warehouse who were eventually bought out by Tiscali (now TalkTalk). With Compuserve, they provided a “Home Page Wizard” which was one of the first WYSIWYG webpage editors. I moved to using Microsoft Frontpage and then Frontpage 2000 and learnt to do my own HTML coding to tidy things up (a bit). Since 2009, sunsong.co.uk has been hosted on WordPress.com.

Here are some screenshots of the Sunsong Home Page over the years:

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“Best of Health”: July 2016 – The Great British Puppy Survey

Best of HealthI’ve recently finished reading The Great British Puppy Survey 2016 which was organised by a group of independent dog and animal welfare campaigners. They are Canine Action UK, CARIAD, Hidden-in-sight, The Karlton Index, Naturewatch Foundation and Pup Aid.

This group wanted to examine the behaviours and attitudes of UK puppy buyers to provide data that might inform future campaigns and policy-making, with the overall aim of improving welfare outcomes for dogs.

The online survey ran for a year (January 2015 – January 2016) and received 4303 responses, of which 3670 were described as “complete”. The responses comprise both quantitative and qualitative data, from a mixture of multiple choice/ranking questions and free text questions.

The first question you have to ask is to what extent that sample size is statistically significant. If it’s not, then any conclusions and, more importantly, any recommendations may be flawed.

Virtually all the puppies (97%) were purchased by survey respondents between 2010 and 2015 (6 years), a period when a reasonable estimate of total UK puppies bought would be 750,000 per year. Given that population, a quick test shows that a sample of 4000 responses would lead to a Confidence Interval of +/- 1.55 at the 95% Confidence Level. In other words, we can consider this to be a big enough sample upon which to draw statistically significant conclusions. We do, however, also have to consider the potential biases in the sample and their responses.

70% of people had bought a pedigree dog and many of those who had bought a crossbred had chosen a so-called Designer Breed, such as a Cockapoo or Cavachon. Interestingly, 80% of people had previous experience of owning a dog, so this does introduce a particular bias to the results. You would assume that the buying attitudes and behaviours of people with previous dog-owning experience would be somewhat different to those who had never owned a dog.

Unfortunately, the data presented in the report has not been analysed in this way, but it would be very easy to do this. I would be really interested to see if new owners were less rigorous in their research and decision-making process than experienced owners, or if they ended up with puppies that had more health and welfare problems. This could be important to help determine whether communications to the two groups should be different. There has been some interesting evidence published, based on Government (HMRC) “nudge” communications. Using language that is tailored to the audience has improved compliance rates in letters about tax returns. For example, “9 out of 10 small business owners like you have already submitted their Tax Return” gets a better response than “your Tax Return is overdue”. A similar approach could perhaps be used with puppy buyers to help them in their decision-making.

Pre-purchase Research

Half the respondents researched both “responsible dog ownership” and ”different breeds” via books, magazines and the Internet before buying their dog and 1 in 8 consulted the KC for advice. 15% asked their vet for advice, which I suspect is a reflection of the number of existing/previous owners in the sample. I’d be surprised if a first-time buyer would consult a vet. Perhaps surprisingly, 15% also visited dog shows to find out about their preferred breed. This is obviously encouraging and a good reason to make shows welcoming to visitors. Only 2% of these respondents did no research, which again suggests to me that many of the responses are slightly skewed by the 80% who had previously owned dogs.

Online classified websites were the main source of adverts, with Pets4Homes being used by about a third of buyers. Having found a breeder (or seller), nearly one-third did an online search for that person’s name. That, I think is interesting and positive as it is more likely to throw up articles on puppy farmers and welfare issues that have made it into the public domain.

Puppy sellers

There appears to be significant confusion among the puppy-buying public about licensing, KC Registration and accreditation (e.g. ABS membership). Half the respondents did not know the difference between people who were selling KC Registered puppies and those who were ABS members. In another question, buyers ranked “the seller was licensed” at number 7 in importance to their buying decision, compared with “able to see mum” and “right breed, sex, temperament” which were ranked first and second. It would appear that “licensing” or accreditation are not high in the priorities of buyers and, given the numerous puppy farm TV programmes where premises are licensed, there is probably still a big credibility gap to bridge. I wonder if the tarnished reputation of Local Authority licensing is carried over into scepticism over the value of the ABS. Surely, UKAS accreditation is the factor that differentiates the two.

In this survey, 80% of buyers saw the puppy’s mother when they bought their puppy. That leaves a shocking one-fifth who didn’t and suggests the “See Mum” message has much more work to do. Add to that the evidence that dealers and other less reputable sellers are setting up “fake Mum” situations to hoodwink buyers and it’s clear that “see Mum” might be overly simplistic as a single message to buyers.

Post-purchase experiences

One in five buyers reported problems with their puppy that required veterinary treatment. Of those, just over a third developed symptoms within the first week of ownership, with 1 in 20 facing vet bills of over £3000.

It’s probably not surprising that so many issues emerged in the first week of ownership as it can be a stressful transition for any puppy, however well-reared, as it moves to its new home. However, there is plenty of research evidence that the temperaments of poorly-reared puppies are worse than those from a good welfare background and you would assume that well-reared puppies will have a less traumatic transition. This also raises a strong argument for puppies to have only one transition; that is from their breeder to their new home. Transport between commercial breeders and retailers, via dealers, and time spent in pet shops cannot be good for the welfare of any puppy.

Puppy owners in this survey also appear to have been either unaware or unclear where they could complain if their puppy had problems. 72% took no action, while others typically complained to the KC, Local Authority, Trading Standards or the RSPCA. With this range of reporting, it would probably be very difficult to identify recurring issues from particular sellers. More than half the owners who had problems found their seller to be “very helpful” and only 6% said they were “completely unhelpful”.

Did these buyers learn any lessons?

More than half the buyers claimed they would do nothing differently and it would be really useful to know how this differed, if at all, between new owners and those who had previously owned a dog.

Surprisingly, nearly one third said that, next time, they would rehome from a rescue centre. This perhaps suggests they are looking for some degree of certainty about who the seller is, but they may not have considered why a dog might be in rescue in the first place. It’s certainly debatable whether there are sufficient dogs in rescue to meet this potential level of demand.

The other main lessons learnt were: visit the puppy at least twice before purchase, see the puppy interact with its mother, request health test results, ask more questions and do an online search for the seller’s name. It strikes me that if we could achieve this combination of buying behaviours it could make a significant difference to the puppy-buying process and would make it significantly more difficult for high-volume, poor-welfare breeders to continue their trade.

Next steps: See Mum Twice!

The report suggests that further analysis of the responses will be carried out and acknowledges that more data is needed on the behaviours and experiences of first-time puppy buyers. Both of these will, I’m sure, be helpful.

The current licensing and inspection system is clearly flawed and failing, but the chances of politicians addressing this anytime soon seem remote.

I’ve said before “if you wait for the perfect set of data, you’ll wait a very long time” and there are certainly some actions that can be taken quickly to help nudge buyers in the right direction and to make it more difficult for low-welfare sellers to get away with it. “See Mum twice” could be a key message that has the potential to make a big difference.

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“Best of Health” – June 2016: “I can explain it to you, but I can’t make you understand”

Best of HealthA recent topic of conversation among Breed Health Coordinators in their Facebook Group was how best to communicate scientific concepts and reports to “ordinary breeders and exhibitors”. It’s not the first time and I doubt it will be the last time this topic has had an airing. Getting the answer right is a key element of any Breed Improvement Strategy because, without effective communication, it’s highly unlikely that we will achieve the support and actions needed to make dogs’ lives better.

Albert Einstein is reported to have said “You don’t really understand something unless you can explain it to your grandmother”, so maybe we should be applying the “granny test” every time we try to communicate important health information. Of course, underpinning this quote is the assumption that your granny doesn’t have a PhD in Canine Genetics, in which case the life of a Breed Health Coordinator would be so much easier!

We aren’t the only community that faces this challenge, so maybe we should try to learn from those who (usually) make science accessible to the masses. The likes of Brian Cox, Alice Roberts and even comedian Dara O’Briain have become recognised TV personalities with their science programmes.

According to the 2014 IPSOS MORI survey of UK public attitudes to science, 72% of respondents said they thought it was important to know about science, compared with 57% in 1988. 90% thought scientists make a valuable contribution to society, but worryingly, a third thought scientists adjust their results to get the answers they want. It would be interesting to see what those responses would be from the dog show/breeder community who have been bombarded with science, genetics and health survey data over the past decade.

Journalists and the press love a good headline; “KC survey reveals apocalyptic drop in purebred dog longevity” hit the streets (or a blog) shortly after the KC published its 2014 Health Survey reports. A recent Vet Times blogger commented on the headline “Majority of pedigree dogs suffer no disease condition, survey shows”. The “majority” was 65%, which the blogger (a vet) rightly pointed out also meant that more than one third of the population did suffer from some disease. Poor communication of important science and data can have significant consequences. It can damage reputations or, at worst, it can lead to harmful decisions and actions. For example, the West African Ebola outbreak required really clear communication of scientific information to large numbers of people with diverse cultural backgrounds so they could take the best possible precautions.

A recent study of factors that caused articles about human vaccination to go viral on social media showed the most shared articles contained:

  • Statistics demonstrating the case being made, plus…
  • A bottom-line message with clear advice for the reader

Both factors had to be present for maximum impact. Articles that were just stories or without statistics, were least likely to be shared. Interestingly, articles that acknowledged both sides of an argument (such as acknowledging occasional adverse vaccine reactions) before coming out with a clear bottom-line message were also seen to have high credibility.

What can we do to improve our chances of people reading and understanding canine science?

I’d probably boil it down to two principles: Plain English and pictures!

According to a 1992 study by the US Department of Education, 90 million English-speaking adults have literacy skills in the lowest two levels. Plain English helps people understand canine science because the writing style is clear, concise and free from jargon. There are plenty of plain-English guidelines and techniques, such as using short sentences and the active voice. This is not the place to spell them out; they are widely available online. We also need to think about other aspects, such as making the message matter to the reader, explaining concepts using information they already know and deciding what details to leave out.

People tend to learn best when they are interested in something and when they can directly relate it to themselves. If we can answer the “what’s in it for them?” question, they are more likely to read and understand. So, increased genetic diversity means they are more likely to have bigger litters and fewer puppy deaths. A lower Coefficient of Inbreeding means they are less likely to find inherited diseases cropping up in their puppies.

When I first learnt to be a trainer, I was taught that it helps to start with what is familiar and build new concepts from the known to the unknown. For example, most people know how uncomfortable it is to get an eyelash rubbing on their eye, so it’s an easy analogy to make when explaining the health impact of Entropion or Distichiasis. Some dogs have to live with these but they aren’t as quickly sorted as getting that eyelash out of your own eye. It might be simplistic, but it gets the point across.

Another danger when communicating scientific information is the tendency to include every last detail. Those who understand, or created the information, may think every detail is important. However, some things just aren’t as important when you’re trying to explain something that is new to the audience. This is a classic dilemma when trying to explain statistical significance to a lay audience. It’s probably perfectly adequate, for that audience, to say a result is statistically significant, but not important to quote Confidence Levels or p-values. However, it is important to ensure a lay audience understands that Correlation does not imply Causation. The well-publicised study of neutering in Golden Retrievers showed neutered dogs had double the occurrence of HD compared to entire dogs. The paper, rightly, did not say “Neutering causes HD”. Knowing what to leave out, is important. The aim is to help someone understand a difficult subject.

Plain English is not “dumbing-down”. It is about clear and effective communication, nothing less.

A picture paints a thousand words.

One of the ways to grab an audience’s attention is to use pictures and, increasingly, infographics are being used to present scientific data. Instead of telling your story using lots of words, you present your message in a more visual way, using eye-catching design elements. Many people love facts and figures, so if you can present them in a compelling way, you can really make an impact. The brain processes visuals faster than text; it’s easier to understand the effect of epilepsy by looking at a short video than by reading about it. Infographics are 30 times more likely to be read than a text article, according to one marketing study.

By an odd coincidence, most of my Best of Health articles contain about 1000 words. Maybe I should save you all the effort of reading them and simply send the Editor a picture each month!

Best of Health 0615

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Buying & owning a Dachshund – an online course

The_Pet_Professionals_-_Poster_-_Buying_and_Owning_a_Dachshund__2_

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