Construction and validation of a risk-screening questionnaire for the investigation of recurrent airway obstruction in epidemiological studies of horse populations in Great Britain.
Abstract: Recurrent airway obstruction (RAO) is an environmental respiratory disease affecting horses. A risk-screening questionnaire (RSQ) for RAO would provide a useful tool to investigate the epidemiology of the disease in horses; our aim in this study was to construct and validate such an instrument. Guidance for what questions to include in the RSQ came from three processes: a review of the scientific literature, a survey of equine practitioners in the UK and a consultation with 19 experts using a modified Delphi technique. The latter consultation consisted of two rounds; agreement amongst the experts increased between the rounds. The quantitative outputs provided estimates of the probabilities of a horse having RAO for each particular piece of historical information or clinical sign. The RSQ for RAO was a short questionnaire for completion by horse owners regarding the horse, its health and its management. The likelihood of a horse having RAO (the RAO score) was calculated from a completed RSQ by combining the relevant estimated probabilities. The RSQ was validated against a reference standard of a veterinary diagnosis including respiratory cytology. This was achieved by inviting veterinary surgeons (residing in Great Britain who had taken part in the practitioner survey, and who had indicated that they used respiratory cytology in the diagnosis of respiratory cases) to participate. During 2003 and 2004 these veterinary surgeons returned RSQs for 40 cases that underwent investigation of the respiratory tract and 40 controls; 18 of the cases were given a final diagnosis of RAO. A receiver-operating characteristic (ROC) curve was used to select a positive cut-off of 0.87 for the RSQ for RAO. This suggested that the RSQ had a sensitivity of 0.83 (95% confidence interval=0.59-0.96) and specificity of 0.85 (0.74-0.93) for the diagnosis of apparent RAO (compared to all other diagnoses).
Publication Date: 2006-02-20 PubMed ID: 16488493DOI: 10.1016/j.prevetmed.2006.01.001Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
- Validation Study
- Clinical Study
- Diagnosis
- Diagnostic Technique
- Disease control
- Disease Diagnosis
- Disease Etiology
- Disease Management
- Disease Treatment
- Epidemiology
- Equine Health
- Horse Owners
- Horses
- Questionnaires
- Recurrent Airway Obstruction
- Respiratory Disease
- Respiratory Health
- Risk Factors
- Veterinary Care
- Veterinary Practice
- Veterinary Research
- Veterinary Science
Summary
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The research discusses the construction and validation of a risk-screening questionnaire (RSQ) for Recurrent Airway Obstruction (RAO), a respiratory disease that affects horses. The RSQ could be pivotal in investigating the epidemiology of RAO, and it was developed after reviewing scientific literature, conducting surveys, and expert consultations. The questionnaire, intended to be completed by horse owners, helped calculate the likelihood of a horse having RAO. It was validated against the reference standard of veterinary diagnoses, which included respiratory cytology.
Development of the Risk-Screening Questionnaire (RSQ)
- The research team constructed the RSQ basis three methods: a review of the scientific literature associated with RAO, a survey of equine practitioners in the UK, and a consultation with 19 experts using a modified Delphi technique.
- This Delphi process consisted of two rounds of consultation, and the research team reported an increase in agreement amongst the experts between the two rounds of the Delphi process.
- These consultations provided the quantitative data necessary to estimate the probabilities of a horse experiencing RAO based on each specific piece of historical information or clinical sign obtained from the questionnaire.
Validating the RSQ
- The RSQ designed was then validated against a reference standard of a veterinary diagnosis that included respiratory cytology.
- For this process, the team invited veterinary surgeons in Great Britain who had participated in the original survey and who indicated that they utilized respiratory cytology in the diagnosis of respiratory cases to participate in the validation process.
- During the years 2003 and 2004, veterinary surgeons returned RSQs for 80 horses (40 cases and 40 controls). 18 out of the 40 case horses were finally diagnosed with RAO.
Evaluating the RSQ’s Performance
- The research team used a receiver operating characteristic (ROC) curve to determine a positive cut-off of 0.87 for the RSQ for RAO.
- The team concluded that the RSQ had a sensitivity of 0.83 (with a 95% confidence interval of 0.59 to 0.96) and a specificity of 0.85 (with a 95% confidence interval of 0.74 to 0.93) for the diagnosis of apparent RAO compared to all other diagnoses.
- This finding suggested that the RSQ could be a robust and sensitive tool for screening for RAO among horse populations in Great Britain.
Cite This Article
APA
Hotchkiss JW, Reid SW, Christley R.
(2006).
Construction and validation of a risk-screening questionnaire for the investigation of recurrent airway obstruction in epidemiological studies of horse populations in Great Britain.
Prev Vet Med, 75(1-2), 8-21.
https://doi.org/10.1016/j.prevetmed.2006.01.001 Publication
Researcher Affiliations
- Division of Companion Animal Sciences, Institute of Comparative Medicine, Faculty of Veterinary Medicine, University of Glasgow, Bearsden Road, Glasgow G61 1QH, UK.
MeSH Terms
- Airway Obstruction / diagnosis
- Airway Obstruction / epidemiology
- Airway Obstruction / veterinary
- Animals
- Case-Control Studies
- Delphi Technique
- Female
- Horse Diseases / diagnosis
- Horse Diseases / epidemiology
- Horses
- Humans
- Male
- ROC Curve
- Recurrence
- Risk Factors
- Sensitivity and Specificity
- Surveys and Questionnaires / standards
- United Kingdom / epidemiology
Citations
This article has been cited 4 times.- Bond S, Léguillette R, Richard EA, Couetil L, Lavoie JP, Martin JG, Pirie RS. Equine asthma: Integrative biologic relevance of a recently proposed nomenclature. J Vet Intern Med 2018 Nov;32(6):2088-2098.
- Laing G, Christley R, Stringer A, Aklilu N, Ashine T, Newton R, Radford A, Pinchbeck G. Respiratory disease and sero-epidemiology of respiratory pathogens in the working horses of Ethiopia. Equine Vet J 2018 Nov;50(6):793-799.
- Léguillette R, Steinmann M, Bond SL, Stanton B. Tracheobronchoscopic Assessment of Exercise-Induced Pulmonary Hemorrhage and Airway Inflammation in Barrel Racing Horses. J Vet Intern Med 2016 Jul;30(4):1327-32.
- Bosshard S, Gerber V. Evaluation of coughing and nasal discharge as early indicators for an increased risk to develop equine recurrent airway obstruction (RAO). J Vet Intern Med 2014 Mar-Apr;28(2):618-23.
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