A first step towards objective grading of equine laryngeal function.
Abstract: Due to concerns about disagreement between veterinarians when grading resting laryngeal function (LF), a diagnostic decision tree (DDT) has been developed by codifying the Havemeyer grading system and objectively defining certain terms to remove ambiguity. Videoendoscopic examinations of the equine larynx that had previously been assigned a unanimous LF grade by 3 experienced observers were used to develop the DDT and determine the cut-off values. The DDT is a flow chart consisting of a series of dichotomous (yes/no) decisions, to dictate the order of decision making and direct the observer down a pathway towards the most appropriate LF grade. To use the DDT, the observer must know the frame rate of the video and use frame-by-frame video playback when reviewing the videos. The first decision involves determining if full left arytenoid cartilage (LAC) abduction is achieved (≤ grade III.1), or not achieved (> grade III.1). Maintained full LAC abduction (≤ grade II.2) is defined as maintenance of full abduction for ≥ 0.2 seconds. Full LAC abduction that is achieved but not maintained (grade III.1) is defined as maintenance of full abduction for < 0.2 seconds. Arytenoid abductor deficit is categorized into left arytenoid abduction ≥45° from vertical midline (grade III.2) and <45° abduction (grade III.3). The DDT could be used as a first step towards computer assisted laryngeal function grading.
Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.
Publication Date: 2024-10-26 PubMed ID: 39490435DOI: 10.1016/j.tvjl.2024.106259Google Scholar: Lookup
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Summary
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The research presents a diagnostic decision tree (DDT) developed as a tool to standardize the grading system for assessing resting laryngeal function (LF) in horses. The DDT offers an objective approach, eliminating potential disagreement between veterinarians using the traditional Havemeyer grading system.
Objective of the Research
- The primary aim of this study was to develop an objective tool that could be used by veterinarians to grade the laryngeal function (LF) in horses.
- This objective tool, referred to as a diagnostic decision tree (DDT), was designed to help veterinarians make clear-cut, objective decisions by removing the ambiguity often associated with previous grading methods.
- The DDT is aimed at strengthening the assessment process and reducing inconsistencies or disagreements between different veterinarians.
Methods Used for the Research
- To form the DDT, the researchers used videoendoscopic examinations of the equine larynx from horses that previously had unanimous LF grades provided by three experienced observers.
- The DDT is structured as a flowchart with a series of binary (yes/no) decisions that guide the observer to the most appropriate LF grade.
- To utilize the DDT accurately, practitioners must know the frame rate of the video recording and use frame-by-frame video playbacks for their observations.
Key Findings of the Study
- The DDT begins by determining if the left arytenoid cartilage (LAC) is fully abducted ( grade III.1).
- A fully abducted LAC that is maintained for >= 0.2 seconds is classified as <= grade II.2, while full LAC abduction that is achieved but not maintained, i.e., sustained for < 0.2 seconds, is categorized as grade III.1.
- Furthermore, the study categorizes arytenoid abductor deficit into two distinct categories – left arytenoid abduction >=45 degrees from the vertical midline (grade III.2) and <45 degrees abduction (grade III.3).
- The DDT, according to the researchers, could potentially be used as a stepping stone towards a computer-based grading system for laryngeal function.
Cite This Article
APA
Hardwick J, Ahern B, Franklin S.
(2024).
A first step towards objective grading of equine laryngeal function.
Vet J, 308, 106259.
https://doi.org/10.1016/j.tvjl.2024.106259 Publication
Researcher Affiliations
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, South Australia 5317, Australia; School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia 6150, Australia. Electronic address: j.hardwick@murdoch.edu.au.
- School of Veterinary Science, University of Queensland, Gatton, Queensland 4343, Australia.
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, South Australia 5317, Australia.
Conflict of Interest Statement
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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