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Comparison of three acute colic pain scales: Reliability, validity and usability.
Abstract: A valid, reliable and usable scale is needed for assessing severity of acute abdominal pain in horses. The study aim was to compare three different scales: (1) the equine acute abdominal pain scale (EAAPS); (2) a scale described by Mair and Smith (2005; M and S); and (3) a numerical rating scale (NRS). Forty brief films of horses (35 of colic cases and five of control horses) were randomly presented to 46 equine veterinarians from different countries. Participants, randomly divided into three groups, each used one scale. Five randomly selected films were shown twice for determining intra-observer reliability. Speed, ease of use and face validity of the scales were evaluated based on expert opinion. Response rate was excellent: 89% for the EAAPS (16/18), and 100% for the M and S (18/18) and NRS groups (10/10). The intraclass correlation (ICC) of 0.86 [95% confidence interval (CI); 0.80-0.92] for EAAPS indicated significantly better inter-observer reliability compared to 0.68 for the M and S and 0.71 for the NRS. Moreover, intra-observer reliability of EAAPS (weighted κ 0.95 [95%CI; 0.92-0.98]) was superior to the other scales (weighted κ 0.78, 0.77, for the M and S and NRS, respectively). Other validity measures (convergent, extreme group, predictive validities), usability (time taken to score the films-speed) and the ease of use of the scales were not significantly different. Face validity (endorsement by experts) was better for the M and S scale than for the EAAPS. The EAAPS showed superior reliability, the M and S scale better face validity, with comparable usability and other tests of validity.
Copyright © 2019 Elsevier Ltd. All rights reserved.
Publication Date: 2019-01-21 PubMed ID: 30902193DOI: 10.1016/j.tvjl.2019.01.004Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Comparative Study
- Journal Article
- Validation Study
Summary
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This research involves comparing the reliability, validity, and usability of three scales used for measuring acute abdominal pain in horses. The results demonstrated that while all three scales had similar usability and other validity measurements, the equine acute abdominal pain scale (EAAPS) showed superior reliability. However, a scale described by Mair and Smith in 2005 had better endorsement from experts.
Study Aim and Methodology
- This study aimed to compare the reliability, validity, and usability of three scales used for assessing the severity of acute abdominal pain, or colic, in horses. The scales were: the equine acute abdominal pain scale (EAAPS), a scale developed by Mair and Smith in 2005 (M and S), and a numerical rating scale (NRS).
- The study method involved the use of forty short films with 35 showing horses with colic and 5 as control horses. These images were randomly shown to 46 equine veterinarians from different countries.
- To ensure diverse responses, the participating veterinarians were divided into three groups to use each of the three scales. For evaluating the repeatability of the scale usage (intra-observer reliability), five randomly selected films were presented twice.
Reliability and Validity Results
- The EAAPS scale showed a higher inter-observer reliability with an intraclass correlation (ICC) of 0.86, which was better than the 0.68 for M and S and 0.71 for NRS. This means that the EAAPS could more consistently distinguish between severe and non-severe colic pain cases across different observers. The intra-observer reliability for EAAPS was also higher, indicating repeatability when used by the same observer over time.
- Validity is the ability of the scale to measure what it is intended to measure. Here, the EAAPS, M and S, and NRS showed no significant difference in convergent validity (correlation to other valid scales), extreme group validity (ability to distinguish between extreme cases) or predictive validity (accuracy in predicting outcomes).
Usability and Face Validity Results
- The time taken to score the films (usability) was found to be not significantly different across the three scales. This reflects that in terms of speed and ease of use, all three scales were comparable.
- Face validity refers to the degree to which a measurement or test appears effective in terms of its stated aims. In this case, the M and S scale had better endorsement by the expert participants, hence higher face validity. This points to acceptance and trust in this scale among the practitioners.
Conclusion
- Overall, the EAAPS showed superior reliability, indicating that it was consistent in measuring acute colic pain among different veterinarians and over repeated measurements by the same observer.
- However, for acceptance and trust among the veterinarians (as reflected by face validity), the M and S scale was superior.
- Usability of the scales and their performance on other validity measures were comparable, implying similar effectiveness in real-world settings.
Cite This Article
APA
Sutton GA, Atamna R, Steinman A, Mair TS.
(2019).
Comparison of three acute colic pain scales: Reliability, validity and usability.
Vet J, 246, 71-77.
https://doi.org/10.1016/j.tvjl.2019.01.004 Publication
Researcher Affiliations
- Koret School of Veterinary Medicine-Veterinary Teaching Hospital, The Robert H. Smith Faculty of Agriculture, Food and Environment, POB 12, Rehovot, 7610001, Israel. Electronic address: gila.sutton@mail.huji.ac.il.
- Koret School of Veterinary Medicine-Veterinary Teaching Hospital, The Robert H. Smith Faculty of Agriculture, Food and Environment, POB 12, Rehovot, 7610001, Israel.
- Koret School of Veterinary Medicine-Veterinary Teaching Hospital, The Robert H. Smith Faculty of Agriculture, Food and Environment, POB 12, Rehovot, 7610001, Israel.
- Bell Equine Veterinary Clinic, Mereworth, Maidstone, Kent ME18 5GS, UK.
MeSH Terms
- Acute Pain / veterinary
- Animals
- Colic / physiopathology
- Colic / veterinary
- Female
- Horse Diseases / physiopathology
- Horses
- Male
- Observer Variation
- Pain Measurement / veterinary
- Random Allocation
- Reproducibility of Results
- Veterinarians
Citations
This article has been cited 7 times.- Kschonek J, Twele L, Deters K, Miller M, Reinmold J, Emmerich I, Hennig-Pauka I, Kemper N, Kreienbrock L, Wendt M, Kästner S, Grosse Beilage E. Part I: understanding pain in pigs-basic knowledge about pain assessment, measures and therapy. Porcine Health Manag 2025 Mar 11;11(1):12.
- Chiavaccini L, Reed RA, Spadavecchia C. Editorial: Advancements in equine pain management. Front Pain Res (Lausanne) 2025;6:1547764.
- Ferlini Agne G, May BE, Lovett A, Simon O, Steel C, Santos L, Guedes do Carmo L, Barbosa B, Werner LC, Daros RR, Somogyi AA, Sykes B, Franklin S. Horse Grimace Scale Does Not Detect Pain in Horses with Equine Gastric Ulcer Syndrome. Animals (Basel) 2023 May 12;13(10).
- Barreto da Rocha P, Driessen B, McDonnell SM, Hopster K, Zarucco L, Gozalo-Marcilla M, Hopster-Iversen C, Esteves Trindade PH, Gonzaga da Rocha TK, Taffarel MO, Alonso BB, Schauvliege S, Luna SPL. A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses. PLoS One 2021;16(8):e0255618.
- de Oliveira MGC, de Paula VV, Mouta AN, Lima IO, de Macêdo LB, Nunes TL, Trindade PHE, Luna SPL. Validation of the Donkey Pain Scale (DOPS) for Assessing Postoperative Pain in Donkeys. Front Vet Sci 2021;8:671330.
- Trindade PHE, Taffarel MO, Luna SPL. Spontaneous Behaviors of Post-Orchiectomy Pain in Horses Regardless of the Effects of Time of Day, Anesthesia, and Analgesia. Animals (Basel) 2021 May 31;11(6).
- Maskato Y, Dugdale AHA, Singer ER, Kelmer G, Sutton GA. Prospective Feasibility and Revalidation of the Equine Acute Abdominal Pain Scale (EAAPS) in Clinical Cases of Colic in Horses. Animals (Basel) 2020 Nov 29;10(12).
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