Letter regarding “Fuzapladib in a randomized controlled multicenter masked study in dogs with presumptive acute onset pancreatitis”

Another limitation is the lack of data on the proportion of dogs treated as outpatients (presenting with milder clinical signs and requiring less care) compared with those requiring intensive care. Because IV fluid administration is the cornerstone of AP treatment, detailed information on the number of dogs receiving fluids (including volume and duration) in each group should be disclosed to assess the efficacy of fuzapladib for variable severities of AP. Additionally, the decision to include dogs with pre-existing medical conditions (with no information on the nature, management, and distribution of these conditions across groups) is another concern that could have influenced treatment outcomes and impacts the validity of the study. To conduct statistical analyses with the primary outcome being the change score, the dependent variable must satisfy several requirements, including having a linear relationship between the post-treatment and the baseline value, avoiding floor/ceiling effects, and having a “smooth” distribution. 7 It is unlikely that several of these conditions were met in this study. [...]it would be more appropriate to use the untransformed MCAI score after treatment and adjust the results for baseline as a covariate. 8 The authors state that they have included the MCAI at baseline as a covariate in the model, which may account for these differences and justify the use of change scores.