By Andrea Short
Patient and public involvement and engagement (PPIE) has become a cornerstone of high-quality human clinical research, and evidence shows that actively involving patients, caregivers, and the public in designing and conducting research makes studies more relevant, ethical, and impactful. While these principles are well established in human research, they are less widely applied in veterinary medicine, most likely due to the absence of a clear, practice-relevant framework rather than a lack of willingness within the profession.
Humanimal Trust advocates for equal access to medical care for both humans and animals. To support this, the organisation is exploring Public Guardian Involvement & Engagement (PGIE) as a way of translating the principles of PPIE into veterinary practice. PGIE brings the voices of animal guardians, the public, and wider professionals into discussions about ethical research and supports the One Medicine ethos of ensuring all patients—human or non-human—have equal opportunities to receive the best possible healthcare, where it is in their best interests.
Importantly, PGIE is advisory, not directive. It is designed to complement—not replace—clinical expertise, professional judgement, or existing ethical and regulatory frameworks. Used well, PGIE can support veterinary clinicians by improving study design, transparency, and trust, without compromising animal welfare or adding unnecessary burden.
This blog explores how PPIE has strengthened human clinical research, what veterinary medicine can learn from this experience through PGIE, and how engaging guardians and stakeholders can support better-designed clinical studies, improved outcomes, and stronger collaboration across species—at a time when interest in One Medicine is growing.
Understanding PPIE in Human Clinical Research
PPIE is about research conducted “with” or “by” patients and the public, rather than “for” them. This includes activities such as:
- Helping to identify research questions that matter most to patients
- Co-designing study protocols to reduce participant burden
- Providing feedback on patient-facing materials, such as information sheets and consent forms
- Participating in advisory panels to guide ethics, feasibility, and dissemination
Research consistently shows that studies incorporating PPIE are more likely to recruit effectively, retain participants, and address outcomes that are meaningful to patients. The UK National Institute for Health and Care Research (NIHR), for example, highlights how PPIE can improve feasibility, reduce avoidable costs, and strengthen trust between researchers and participants.
Beyond practical benefits, PPIE raises ethical standards. Involving patients and the public early helps identify potential concerns, misunderstandings, or unintended burdens that may otherwise be overlooked, ensuring studies respect lived experience as well as scientific rigor.
Translating the Concept: PGIE in Veterinary Clinical Research
Veterinary clinical research faces many of the same challenges as human clinical research: namely ensuring relevance, feasibility, and ethical robustness within real-world clinical settings. While veterinary patients cannot advocate for themselves, their guardians can provide valuable insight into what matters most and what is practical in everyday care.
PGIE mirrors the principles of PPIE but is adapted specifically for veterinary medicine. It aims to involve animal guardians (owners), animal welfare advocates, and wider stakeholders in ways that support, rather than complicate, clinical research. This may include:
- Identifying research priorities that benefit animal health and welfare
- Assessing the acceptability and feasibility of studies in daily life
- Reviewing study materials to ensure clarity and transparency for guardians
- Advising on ethical considerations where interventions involve uncertainty or risk
Crucially, PGIE aligns with existing professional and ethical standards, including those set by bodies such as the RCVS. It does not shift responsibility away from clinicians, but instead provides additional perspectives that can strengthen ethical decision-making and communication.
Real-World Examples of Impact
Consider a study investigating new diagnostic approaches for osteoarthritis in dogs. Researchers might prioritise outcomes that are clinically relevant but difficult for owners to observe or report, such as subtle imaging changes. Through PGIE, guardians can highlight outcomes that reflect daily quality of life—mobility, comfort, activity levels—ensuring the research remains both clinically meaningful and practically relevant.
PGIE can also help veterinary teams navigate ethical complexity. Interventions that are routine in human medicine may require careful discussion in veterinary contexts to ensure welfare remains paramount. This mirrors how PPIE informs consent, safeguards, and communication in human trials.
Why PGIE Matters for One Medicine
One Medicine seeks to advance health through collaboration across species. PGIE strengthens this approach for veterinary medicine by:
- Enhancing relevance: Research focuses on outcomes that matter in real life
- Building trust: Guardians are more likely to engage when they feel heard and respected
- Supporting ethical frameworks: Diverse perspectives help ensure transparency and welfare-led decision-making
- Encouraging collaboration: PGIE can help align veterinary and human research priorities, supporting translational work
At a time when veterinary costs, public expectations around transparency and ethical research are increasing, PGIE offers a constructive way to respond without undermining professional autonomy.
Implementing PGIE in Practice
PGIE does not need to be complex or resource-intensive to be effective. Practical steps include:
- Establishing small advisory groups of guardians or welfare representatives
- Co-designing study materials or surveys with early stakeholder input
- Seeking feedback at key points in the study lifecycle
- Sharing findings with contributors to reinforce trust and engagement
When viewed as an ongoing dialogue rather than a one-off consultation, PGIE can enhance both the quality and credibility of veterinary research.
Conclusion
PPIE has transformed human clinical research by demonstrating that meaningful engagement improves both science and ethics. Translating these principles into veterinary medicine through PGIE offers similar promise: research that is practical, ethically robust, and aligned with the needs of clinicians, guardians, and animals alike.
As One Medicine continues to evolve, PGIE will complement PPIE and ensure that all patients—whether human or non-human—benefit from well-designed, meaningful, and ethically conducted research. Engaging stakeholders is not just good practice; it is essential for advancing ethical, patient-focussed clinical research which is a key aim for One Medicine.
References
- National Institute for Health and Care Research (NIHR). “Patient and Public Involvement in Research.” 2023.
- Humanimal Trust. “One Medicine: Connecting Human and Animal Health.” 2023.
- RCVS Knowledge. “Practice-Based Research in Veterinary Medicine.” 2022.
- INVOLVE. “Briefing Notes for Researchers: Public Involvement in NHS, Public Health and Social Care Research.” 2012.
Find out more about our PGIE Group.