The overall objective of this study was to investigate how relevant research
publications address the validity of diagnostic methods for acute puerperal
metritis (APM) in dairy cows, a disease commonly treated with antibiotic
drugs. Therefore, a literature search was conducted in Journal of Dairy
Science, Theriogenology, Animal Reproduction Science and The Veterinary
Journal utilizing the ScienceDirect database. The search revealed 259 articles
addressing APM. After applying exclusion criteria, a total of 48 trials
remained. It was determined whether the author gave a clear definition of APM,
the time of diagnosis relative to calving, and the person who performed the
diagnosis. Studies were checked for the presence of definitions of possible
findings, thresholds, and test characteristics of the methods used. Overall 9
different diagnostic methods were employed. On average 2·5 ± 1·75 diagnostic
methods were used in a study. References to support the use of the diagnostic
methods were provided in 10 of 48 articles (20·8%). Vaginal discharge,
transrectal palpation and rectal temperature were examined in 39, 22, and 21
of the studies, respectively. Thresholds for diagnostic tests and test
characteristics were mentioned in 6 and 3 of the 48 articles, respectively.
Based on this systematic review of 48 research papers the evidence supporting
the use of the diagnostic methods to identify cows with APM has either been
not reported or is weak. In conclusion, the reporting of the diagnostic
methods to identify cows with APM needs to be improved and further high-
quality research is necessary to improve diagnostic performance of the methods
employed