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Veterinary journal (London, England : 1997)2012; 196(3); 394-401; doi: 10.1016/j.tvjl.2012.10.008

A behaviour-based pain scale for horses with acute colic: scale construction.

Abstract: A validated tool for assessing the severity of acute abdominal pain is needed for the effective management of colic in horses. Two behaviour-based colic pain scales were constructed by combining together mathematical and judgemental approaches. The mathematical approach identified easily-recognised pain behaviours to select as items. The judgemental approach further modified the items and weighted them based on expert-opinion. Thirty equine practitioners assessed the level of pain demonstrated in 23 film clips of clinical cases exhibiting signs of acute abdominal pain prospectively using a 10cm visual analogue scale (VAS). The practitioners also identified behaviours noted in each clip from a checklist of 23 behaviours identified from the literature. Nine behaviours had insignificant bias and moderate-to-excellent inter-observer agreement (multirater kappas: 0.5-0.95). Six experienced veterinarians then completed questionnaires in an iterative Delphi process to independently judge 15 items that best reflected severity of pain out of 42 items generated from the literature. Two behaviours were generated by the process. Subsequently, an advisory panel of three equine practitioners constructed two clinimetric-type scales based on the results of both approaches. The two resulting equine acute abdominal pain scales (EAAPS) included 12 behaviours. One weight was assigned to each behaviour in the EAAPS-1. In the EAAPS-2, gradations of weights were assigned, based on the frequency of the behaviour being demonstrated. The EAAPS scales are the first pain severity scales designed specifically for clinical use in cases of acute colic utilising the clinimetric approach to scale construction. Further studies are underway to validate the scales.
Copyright © 2012 Elsevier Ltd. All rights reserved.
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Publication Date: 2012-11-08 PubMed ID: 23141961DOI: 10.1016/j.tvjl.2012.10.008Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research work sought to develop a verifiable tool for assessing the severity of sudden abdominal pain, known as colic in horses. To construct the proposed behavior-based pain scale, the researchers combined mathematical and judgemental approaches and validated the scales using a series of expert-driven procedures and assessments.

Theory and Approach

  • Two behavior-based scales for evaluating colic pain in horses were created, utilizing both mathematical and judgmental methodologies; both approaches use recognized pain behaviors as key elements.
  • The mathematical approach focused on identifying clear indicators of pain that could be quantitatively measured, while the judgmental approach involved the subjective evaluation and weighting of these indicators by experts.

Scale Construction and Validation

  • The pain levels in 23 video clips of horses demonstrating symptoms of acute abdominal pain were examined by 30 equine practitioners. Their evaluations were done using a 10cm visual analog scale (VAS).
  • These experts also made note of all notable behaviors exhibited by the horses in these clips by referencing a checklist of 23 behaviors previously identified in literature.
  • Out of the 23 behaviors identified, nine were found to have insignificant bias and moderate-to-excellent inter-observer agreement with multirater kappas between 0.5 and 0.95. This process ensured those selected behaviors were reliable for scale construction.
  • An iterative Delphi questionnaire process was then used to determine which items best reflected pain severity. Six experienced veterinarians independently evaluated and selected the top 15 behaviors out of 42. As a result, two key behaviors were identified through this process.

Results and Conclusion

  • Using the results from both mathematical and judgemental approaches, an advisory panel of three equine practitioners constructed two clinimetric-type scales. These scales were then incorporated into the practical equine acute abdominal pain scales (EAAPS).
  • The EAAPS-1 assigned equal weight to each behavior, while the EAAPS-2 used a gradation of weights based on the frequency each behavior was demonstrated in their sample cases.
  • The EAAPS scales, which consist of 12 behavioral indicators, are the first pain severity scales specifically designed for assessing acute colic in horses using the clinimetric approach to measure the severity of pain in horses.
  • The team acknowledges that further studies are needed to validate the scales, but the current studies mark a significant step towards a systematic approach to pain assessment in horses.

Cite This Article

APA
Sutton GA, Dahan R, Turner D, Paltiel O. (2012). A behaviour-based pain scale for horses with acute colic: scale construction. Vet J, 196(3), 394-401. https://doi.org/10.1016/j.tvjl.2012.10.008

Publication

Veterinary journal (London, England : 1997)
ISSN: 1532-2971
NlmUniqueID: 9706281
Country: England
Language: English
Volume: 196
Issue: 3
Pages: 394-401

Researcher Affiliations

Sutton, Gila Abells
  • Koret School of Veterinary Medicine-Veterinary Teaching Hospital, The Hebrew University of Jerusalem, Robert H. Smith Faculty of Agriculture, Food and Environmental Sciences, POB 12, Rehovot 76100, Israel. sutton@agri.huji.ac.il
Dahan, Roee
    Turner, Dan
      Paltiel, Ora

        MeSH Terms

        • Animals
        • Behavior, Animal
        • Colic / pathology
        • Colic / veterinary
        • Female
        • Horse Diseases / diagnosis
        • Horse Diseases / pathology
        • Horses
        • Male
        • Pain / diagnosis
        • Pain / pathology
        • Pain / veterinary
        • Pain Measurement / methods
        • Pain Measurement / veterinary

        Citations

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