09/06/2026
Written by and all credit to Deborah Norris ❤️.
"Why won't HM take up the offer of an independent scientific study"
An essay - sorry folks, it's me, I don't do short posts.
My background/qualifications on this topic: I worked as an engineer in R&D for over 25 years, with c.20yrs in medical devices. I have designed, reviewed, executed, analysed, reported and read through more scientific studies and papers than most folks will have had hot dinners.
TL:DR - there has been no serious approach or offer made. The approach itself is 'unconventional' (social media, instead of direct contact). There are significant holes in the logic of the 'outlined study' which calls into questions significant issues around ethics. Finally, there is a complete absence of indication of funding (and believe me, it would be expensive! - eyewateringly so with a price tag in excess of £0.5M).
Taken together, these are clear hallmarks of a dog-whistle being sounded to the folks who have chosen to follow destructive hate and fear-mongering of HM rather than stump up answers and evidence to prove their case. And it works. But you deserve to understand what is actually involved in a proposed multi-arm study. So I've condensed my decades of experience into this one very long post.
If you want the details to support my above summary - buckle in! (get a cuppa tea first).
I'm going to ignore her intro, laying out personal grievances and throwing out allegations simultaneously. I personally don't care, I'm interested in hoof care and things getting substantially better for horses. Without proof and evidence, I don't want to hear it - and even then, it's not my fight.
The offer: seemingly level headed, full of technical jargon and claims to be aligned with demonstrating the proof of what is taught here. Now, there have been a string of posts from this woman who has a PhD in veterinary science offering to run an 'independent study' where HM trimming forms part of the study arms, and where (importantly) HM would be invited to be part of the study design process.
Wonderful! And indeed, were it a genuine offer, and funded, it would be something of interest.
Why my skepticism? Well - firstly I transcribed her video so I could analyse the outlined offer in detail, I reviewed it, went through a more detailed study design jotted down on paper, and did a quick order-of-magnitude costing for her proposed "6 month" study... and once I checked things in detail, it sounds full of holes to me.
Now - it is worth highlighting, the verbal delivery was for a floated 'outline', not a fully thought through proposal and was framed as a starting point - so we must not judge too harshly, it is not a fully reviewed study design! But it was floated as a 'believable basis' - so we must take that part in good faith.
However, she outlines a proposal for a 4-arm study (each group is referred to as an 'arm' in clinical trials - take it up with the science community). This is ambitious, because as I will demonstrate in a moment, recruitment on her terms will be challenging - if we wish to get sufficient data points out with statistical relevance and control over experimental variables. Whilst most equine studies 'make do' with n = 6, that really won't cut the mustard here. Not if we want to generate hard proof.
She proposes that the study find horses, diagnosed with mild-moderate metabolic disease (i.e. blood tests confirm the horse suffers EMS) or endocrine disease (indication that she means PPID here, which I would think is not sensible to include, given this is different to metabolic disease, although they can have some overlapping symptoms such as flare-ups exacerbated by high sugar loading).
That these horses have been pasture exposed over the proceeding 6 months - so, despite having EMS/PPID, their owners persist on keeping them on grass... unlikely, but ok, we can find some.
Have 'hoof imbalance' (which is TBD in her opinion - aka cue lots of debate) but present with no active or acute laminitis - OK _ RED FLAG. We clearly have someone who does not wish to recognise that mechanical imbalance of the hoof creates inflammation markers in the laminae. Not only that, but there is no diagnostic in-vivo test to demonstrate inflamed laminae, just deduction from x-rays showing certain degrees of separation when taken alongside 'hot hooves and bounding pulses' that there is "laminitis". So from the outset, we don't have any extension of belief that distortion = laminitis (where laminitis is the wrong diagnostic label and criteria altogether is a very long different discussion). Sorry dear, but your prejudice is showing. You might wanna just tuck that back in...
She goes on to define further the inclusion and exclusion criteria - all very normal practices, though there are some ludicrous inclusions such as HPA - PASTERN IS JOINTED IT IS NOT A CONSTANT ANGLE. ANYWAY. She's a vet, not a hoof care specialist. I digress.
Note - she spends a long time expounding all of these criteria, and the clinical presentation to make it sound very well thought out, and it includes all the typical technical jargon of a clinical trial - aka exclusionary tactics for those 'not in the know'. She literally could have explained this in plain English and it would have been more appropriate given the forum on which she is broadcasting this generosity of hers - there is no minimum requirement in scientific literacy to be listening to a FB video.
Impartiality - now - she expounds on impartiality a LOT! Giving much credit to the scientific process being designed in such a way that it mitigates bias of the individual scientists involved. And this is true - up to a point. That point being, it is to guardrail against unconscious bias of the research team - which is why 'blinding' the study researchers becomes prominent, if you don't know what the treatment is, you can't accidentally favour the way you interpret the data. HOWEVER - there is literally no controls over conscious and directed bias. And, this individual has that in spades when it comes to 'evaluating' HM. Indeed, the whole offer is based around clearly misinterpreting or wilfully misunderstanding what HM teach around hoof capsule divergence and metabolic health in horses.
So - no, she is not an independent person and nor are any of the very vocal supporters rattling their cages at her offerings. One couldn't expect her or any of her hand-selected team mates to conduct a study without prejudice into a set of protocols they are extremely prejudiced against. And that prejudice (despite her commentary) is well documented within the comment sections of those who are clearly positioned against all HM has to stand for.
Now - data collection. There needs to be a lot of that. She barely touches on it - but here is where we have COST. And a lot of it.
Statistically, each 'arm' needs to come out with group data on at least 15 specimens, or any statistical work cannot be tested for normal distributions (that means the standard deviation is meaningless when n < 15 in the RESULTS). This is one of the many reasons so many equine research papers have a tagline of 'more research needed, preferably with a larger group' - because recruitment is hard and horses big and expensive to run like lab rats.
Any study of any significant duration (6 months is significant) should expect for there to be drop-outs. No matter how well the screening criteria going in, animals get sick or injured for other reasons that may exclude them from being included in the final results. Over-recruitment is dependent on risk, but an absolute minimum would be 10%; as we can't have 1.5 horses extra per group, that needs to be an additional 2. Each group n = 17.
There are 4 groups in her proposal. We need (as a MINIMUM); 68 horses recruited.
Recruitment costs money, BTW, it's not free. And recruitment criteria she defined involves blood tests and xrays - these need to be covered, as well as the professionals who take and interpret the data.
To recruit 68 horses, you're going to have to screen a lot more than the target number (indeed, you also commonly build a waiting list of extras, in case of drop-outs before study commences). So - you have to screen say 50% over the number you recruit (that is so conservative, it would normally be multiple times the recruitment number, but let's assume we have health history screening first which is substantially cheaper than full health checks).
Detailed screening needs to happen on approx: 100 horses (102 for the pedants who think this needs to be to the letter).
Once we have viable candidates, the owners then need to 'sign over' the care of their horses fully to the study. Because owners and their interactions are variables. They're controllable variables. Visitation rights, yes. Riding/training etc - no. It could skew the resuilts. Tricky getting suitable recruits. As a result, there needs to be benefit to the owner - covering the full cost of their horses livery, feed, veterinary and hoof care for the full period of the study would likely be the minimum. Anyone want to put together figures for 68 horses at full livery with full hoof care (which dear reader includes any fancy glue-ons, wedges, pads, clogs, rockers, heartbars, boots, pads required to keep Neddy sound and comfortable) and vet bills (pain relief, metabolic meds, any accident injuries, viruses etc occurring in 6 months in horses with known metabolic and endocrine disease!)?
All horses need to be managed in the same facility - or the least number facilities where the board and management conditions are, to all intents and purposes - identical. Let's say we have 3 yards that have the capacity - now you have three sets of management and livery staff. Because we can't have the owners interfering with results. You have to have travel between yards for all the trimming teams, because you must have samples from each study arm at each facility so there's no skew-bias from different geographical location (weather, surfaces, herd dynamics).
All livery management staff must have the same training and carry out care protocols for each animal identically.
All feeds must be identical for each test group that is on a like-for-like... the 'grazing groups' in her proposal need to be kept on the same field. Literally. or the groups need to be split so that each field has a half-half population in each of the two fields - and then someone needs to analyse the resulting data for any anomalies - but now each test group split is under 15 results per, so you might end up with skewed data... you could increase your target groups size... Regardless, if you don't, you have another layer of data analyses to perform and could have to make adjustments in your data analysis..
Hahahahaha - I'm not even half way into why this costs so much. Sorry (not sorry).
Vets. Radiographers. Trimmers, Farriers. They all need paid.
So do the researchers, the analysts which include vets and/or radiographers who must be blinded to the active treatment teams. They need paid.
Livery yards and the management team need paid.
Feed, medications, emergency treatment bills - all need paid.
Each review point of the study needs to be funded - and to be in line with HM's standards, there is a full set of radiographs, photos, videos and measurements to be recorded and analysed (two separate teams, blinded to the activity of the other) EACH MONTH.
The study design needs outlined, written up, reviewed.
Then submitted to the board of ethics. They make observations, the paper goes through revisions until it passes. It may not make it, you have an outlay of many thousands of £ EVEN if the study cannot go ahead as proposed! (this is done before screening, it's ok, you don't have that huge cost on the possible failure to start).
Now comes the fun part. How do we get the results for 68 horses taken within an equivalent time-point? I reckon it might be reasonable for 1 vet to process 10 horses in one day for the full set of checks... if all horses are at one facility. Who knows, it might even be they can do 20 (sounds like a lot to get through, given xrays take time, so do bloods). But you can't leave it strung out over many days, certainly not weeks - your study only spans 26 weeks, you have 7 check points including admission, and the horses in each group need to be in the equivalent environmental conditions - including grass - weather dependent much) - so... hmmm. Time sensitivity matters here.
Photos and videos and measurements are taken by trained but don't need to be vets team members. Each horse will likely take at least half an hour - so let's say we can process 17 horses a day (ambitious). 4-days... or do we speed it up by having more teams qualified to do the job?
If we do - we need more pieces of equipment. Including xray machines.
The cameras need to be the same make and model, they need to have rigs to ensure the photos are all taken at the same focal length and distance and lighting is adequately controlled.
Any software used to process any image must also be considered as a piece of equipment.
The calipers used to measure the hooves.
All of it either needs to be duplicated per team - or you must take a hit on staggering the time point for recording results and put all your eggs in one basket when it comes to trained team members.
A study this size, you would make sure at the very least you have a duplicate of everything, and where it is lower cost (such as calipers) you would have many more than that.
The calipers are not your £20 off Amazon jobs - BTW. no. they're scientific instruments. Last time I was buying these, with calibration certificates (so they measure repeatedly and accurately to what they claim they do) - about £400-£500 PER CALIPER is reasonable. That includes the calibration cert. Drop the caliper, it MUST be recalibrated (expect this to take at least 1 week and cost at least £150). So you carry spares of these, as these are - trust me in context of this study equipment needs - low cost.
Sooooooo - why go into all this detail. Because then you might just find it more credible to believe how much this should actually cost. I haven't finished by the way - sorry. Get another cuppa.
Right - we have say 2 teams that can do data recording - this helps provide insurance for people being off sick at data measurement day and also helps process the horses faster when everyone is present. Since a 6 month study with intake recording will have 7 data point recording days per horse - better believe we need insurance!
Okiedokie. That's all good then.
No, we have multiple pieces of equipment and multiple operators for each piece of equipment. Any rigs and fixtures and software are included in 'equipment' by the way.
So now we need to design, review, execute and analyse a Gage R&R (go google it) - this is essentially a study specifically designed to check the operating protocols for each piece of equipment tests for any data skew that may be attributable either to the human (operator) or equipment. If you're looking at 2 operators and 2 pieces of equipment - each operator must use each piece of equipment at least 3 times to measure the same object... and then expand that to multiple objects (typically again at least 3) - because hooves are organic and have 'interpretation' when deciding where to measure them - both in xray and in caliper.
See - now we have this study to run - and you have to pay the people that design it and run it, the people who participate in it, and the people who analyse and report it. (it's all part of the research team - but they need paid). And you need equipment etc etc.
If there are operator or equipment skews in your result - you then need to work out how to mitigate them (e.g. automation, reducing number of operators, extensive training programmes, double checking - e.g. measurements are performed three times and averaged for each measurement; or multiple operators perform measurements to average out the result taken). All of which takes time and - yup, MONEY.
And this is all BEFORE YOU ENTER THE STUDY. You are hundreds of thousands of pounds in before you set a single horse into the study proper.
Welcome to peer reviewed research papers.
NOW - one could of course argue that these steps are unnecessary... but they've been designed for a reason. There's a reason we go to these lengths to control variables and remove skews and biases etc. (technically, originally it was to exclude women and POC from science - but I'm not to get side-tracked). Because it is a lot of time and effort to run a study - so you really want to make sure that the things you record are the right things, they're not subject to 'weird thing happening in my data set' - oh, crap, we forgot to check if Fred measures the same way that Ginger does... start again?
Do-overs are expensive.
Anyway. For fun (I wrote this post for fun, so better believe the budgeting was fun too) - I did a rough costing out. For a smaller study (3-arm, as we don't need the grazing group, but do need a true control group to assess whether Standard of Care is better than 'just how the trimmer deals with the feet regardless of diagnosis'... because that has never been tested folks. Yup, they scream about HM, but literally, their methods are untested and unproven - and the infield data shows alarming trends that should be ringing big alarm bells for them).
That smaller by a whole 17 horses study cost came to around £500,000. That was me being conservative. I didn't go bells and whistles, I estimated the bare minimum. To do a 4 arm study, given much of the cost is in labour and equipment and analysis - would increase the costs significantly - probably not exactly by another third of the cost, but north of £600k is reasonable.
Beware of benign offers of independent scientific rigorous study on the social media pages of axe-grinders. They likely do not wish to put their money where their mouth is.
The side-effect of this post may also help you understand why HM take the approach they do - using a very small dedicated highly trained team to consistently care for each horse and have the time available to make sure each data point taken is performed in an equivalent manner. It is a sane and simple way of reducing the mighty overhead costs of a massed arm study where everything must happen all at once. That and the fact that to-date, HM case studies have been focused on rehabilitation and the effects of balancing the trim - it would be ethically questionable to perform this as a multi arm study since inclusion criteria may never be met for sufficient numbers, it would always be staggered intake and treatment programmes.
Hope you enjoyed your tea. Bonus points if you can identify the labelled parts of this diagram (picture for tax works best on fluffy foals, right?).
