FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Equine veterinary journal2026; doi: 10.1002/evj.70164

Delphi consensus on Thoroughbred yearling sales endoscopy in Australasia.

Abstract: Concerns regarding the reliability and consistency of yearling sales endoscopy in Australia and New Zealand have led to reduced industry confidence. Recent studies have clarified the relationship between yearling laryngeal function (YLF) grades and future outcomes. Objective: To build expert consensus on the most appropriate method for grading YLF, assess the clinical relevance of each grade on future race performance and prosthetic laryngoplasty risk, and develop guidelines for pre-sale endoscopic technique. Methods: Modified Delphi study. Methods: Anonymous, iterative surveys were distributed to expert veterinarians in Australia and New Zealand. Consensus was defined a priori as ≥75% agreement. Surveys included closed and open-ended questions, with qualitative and quantitative data analysed after each round. Panellists received a summary of responses before each subsequent round. Items reaching consensus were excluded from later rounds, and new items were added based on panellist feedback. Results: Three survey rounds were completed, with 40 veterinarians, 39 (97.5%) and 37 (92.3%) respectively. Consensus was achieved on adopting the Havemeyer grading system, standardising pre-sale endoscopic techniques, and implementing a four-tier risk-rating system for YLF grades. Grades I and II.1 YLF were classified as low-risk; grade II.2 as low-moderate-risk; grade III.1 as moderate-risk; and ≥grade III.2 as high-risk. Descriptors were developed to guide risk categorisation based on observed YLF. Conclusions: Steering committee members were involved in prior research. Conclusions: This study provides a foundation for evidence-based guidelines that enhance the transparency, consistency, and animal welfare in yearling sales endoscopy, supporting better-informed purchasing decisions. Unassigned: Bedenken hinsichtlich der Zuverlässigkeit und Konsistenz der Endoskopie bei Jährlingsauktionen in Australien und Neuseeland haben zu einem Rückgang des Vertrauens in die Branche geführt. Jüngste Studien legten den Zusammenhang zwischen Jährlings‐Kehlkopffunktion (YLF) und zukünftigen Ergebnissen dar. Unassigned: Die Erreichung eines Expertenkonsens über die am besten geeignete Methode zur Einstufung von YLF, Bewertung der klinischen Relevanz jeden Grades für die zukünftige Leistungsfähigkeit und Risiko der Notwendigkeit einer prosthetischen Laryngoplastik, sowie Entwicklung von Richtlinien für die endoskopische Technik vor Auktion. Methods: Modifizierte Delphi‐Studie. Methods: Anonyme, interative Umfragen wurden an erfahrene Tierärzte (“Experten”) in Australien und Neuseeland verbreitet. Ein Konsens wurde a priori als eine Übereinstimmung von ≥75% definiert. Die Umfragen umfassten geschlossene und offene Fragen, wobei nach jeder Runde qualitative und quantitative Daten analysiert wurden. Die Panelteilnehmer erhielten vor jeder weiteren Runde eine Zusammenfassung der Antworten. Punkte, über die Einigkeit herrschte, wurden aus späteren Runden ausgeschlossen und auf Grundlage des Feedbacks der Panelteilnehmer wurden neue Punkte hinzugefügt. Unassigned: Es wurden drei Umfragerunden durchgeführt, an denen 40, 39 (97.5%) bzw. 37 (92.3%) Tierärzte teilnahmen. Ein Konsens wurde darüber erzielt, das Havemeyer‐Grading‐System zu übernehmen, die endoskopischen Techniken vor der Auktion zu standardisieren und ein vierstufiges Risikobewertungssystem für YLF einzuführen. Die Grade I und II.1 YLF wurden als risikoarm eingestuft, Grad II.2 als risikoarm bis mäßig, Grad III.1 als mäßig und ≥ Grad III.2 als hoch risikobehaftet. Deskriptoren der Risikokategorisierung auf Grundlage der beobachteten YLF wurden entwickelt. HAUPTEINSCHRÄNKUNGEN: Die Mitglieder des Lenkungsausschusses waren an früheren Forschungsarbeiten beteiligt. Unassigned: Diese Studie bildet die Grundlage für evidenzbasierte Leitlinien, die Transparenz, Konsistenz und den Tierschutz bei der endoskopischen Untersuchung im Rahmen von Jährlingsauktionen verbessern und fundierte Kaufentscheidungen ermöglichen.
© 2026 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
Get Full Text
Publication Date: 2026-04-14 PubMed ID: 41979158DOI: 10.1002/evj.70164Google 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.
LinkedInCopy
  • Journal Article

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.

Overview

  • This study aimed to develop expert consensus on how to grade yearling laryngeal function (YLF) during endoscopy at Thoroughbred sales in Australasia.
  • The goal was to improve reliability, standardize grading systems, assess the clinical relevance of grades for predicting future race performance and surgical risk, and provide guidelines for endoscopic techniques before sales.

Background and Rationale

  • Industry Concerns:

    • There have been concerns in Australia and New Zealand about the reliability and consistency of endoscopy performed on young Thoroughbred horses (yearlings) at sales.
    • This inconsistency has led to decreased confidence among industry stakeholders including buyers and trainers.
  • Importance of Grading Yearling Laryngeal Function (YLF):

    • Yearling laryngeal function grading assesses the condition of the horse’s larynx, which impacts breathing and athletic performance.
    • Previous research has demonstrated links between YLF grades and future outcomes such as race performance and the risk of requiring corrective surgery, particularly prosthetic laryngoplasty.

Study Objectives

  • To establish expert consensus on the most appropriate grading system for assessing YLF in yearlings.
  • To define the clinical relevance of each grade concerning future racing success and surgical risk.
  • To develop guidelines for standardized, pre-sale endoscopic technique to ensure consistent, reliable assessments.

Methods – Modified Delphi Study

  • Study Design:

    • A modified Delphi methodology was used involving iterative, anonymous surveys directed at expert veterinarians in Australia and New Zealand specializing in equine sports medicine and surgery.
    • Consensus was predefined as at least 75% agreement among panelists on a given item.
  • Survey Process:

    • Three rounds of surveys were conducted with participation rates of 100%, 97.5%, and 92.3% respectively (40, 39, and 37 veterinarians).
    • Surveys contained both closed (quantitative) and open-ended (qualitative) questions to capture nuanced expert opinions.
    • After each round, responses were analyzed and summarized, with items that reached consensus removed in subsequent rounds, and new items added based on panelists’ feedback.

Key Results and Consensus Outcomes

  • Grading System Selection:

    • The panel agreed to adopt the Havemeyer grading system for YLF, a detailed classification method.
  • Risk Categorization of YLF Grades:

    • A novel four-tier risk system was developed based on observed YLF grades:
    • Grades I and II.1 classified as low-risk for poor performance or surgery.
    • Grade II.2 classified as low to moderate risk.
    • Grade III.1 classified as moderate risk.
    • Grade III.2 and above classified as high-risk.
  • Standardization of Pre-sale Endoscopic Technique:

    • Consensus was achieved on implementing standardized protocols for performing the pre-sale endoscopy to enhance reproducibility and comparability.
  • Descriptors were created to help veterinarians categorize risk accurately based on endoscopy findings.

Limitations

  • Members of the steering committee who helped design and interpret the study had been involved in prior related research, which might introduce bias.

Conclusions and Implications

  • The study provides the foundation for evidence-based guidelines that:
  • Improve transparency and consistency in endoscopy grading at yearling Thoroughbred sales in Australasia.
  • Enhance animal welfare by ensuring accurate assessment of laryngeal function.
  • Support buyers making more informed purchasing decisions by clarifying the clinical relevance of YLF grades.
  • May stimulate future research to validate and refine grading systems and endoscopic protocols further.

Cite This Article

APA
Hardwick JL, Ahern BJ, Anderson BH, Franklin SH. (2026). Delphi consensus on Thoroughbred yearling sales endoscopy in Australasia. Equine Vet J. https://doi.org/10.1002/evj.70164

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Hardwick, Josephine L
  • School of Animal And Veterinary Sciences, Adelaide University, Adelaide, South Australia, Australia.
  • School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia.
Ahern, Benjamin J
  • School of Veterinary Science, University of Queensland, Brisbane, Queensland, Australia.
Anderson, Brian H
  • Ballarat Veterinary Practice, Ballarat, Victoria, Australia.
Franklin, Samantha H
  • School of Animal And Veterinary Sciences, Adelaide University, Adelaide, South Australia, Australia.

References

This article includes 36 references
  1. Equine Veterinarians Australia. Pre‐sales video endoscopy of the laryngopharynx, version 4. Sydney: Australian Veterinary Association; 2019.
  2. William Inglis and Son Bloodstock Auctioneers. Conditions of sale. 2025 [cited May 15, 2025]. Available from: https://content.inglis.com.au/uploads/documents/COS.pdf
  3. New Zealand Bloodstock. 2025 National yearling sale conditions of sale, Karaka, NZ. 2025 [cited May 15, 2025]. Available from: https://assets.nzb.co.nz/sale‐documents/25kaa/6cab10f0d6225cdddfea71781dfd95d9/25NYSS%20Conditions%20of%20Sale.pdf
  4. American Association for Equine Practitioners. Protocol for pre‐sale videoendoscopic examination of the upper airway at public auction. 2025. Available from: https://aaep.org/resource/protocol‐for‐pre‐sale‐videoendoscopic‐examination‐of‐the‐upper‐airway‐at‐public‐auction/
  5. Keeneland Sales. Conditions of sale. 2025. Available from: https://www.keeneland.com/sales/2025/4/november‐breeding‐stock‐sale/56421/conditions‐sale‐2/
  6. British Equine Veterinary Association. Pre‐sale videoendoscopy guidelines. 2020. Available from: https://www.beva.org.uk/Portals/0/Documents/ResourcesForVets/Performance%20Horses/Pre%20Sale%20Videoendoscopy%20English.pdf 2020
  7. Tattersalls Bloodstock. Conditions of sale. 2025. Available from: https://secure.tattersalls.com/4DCGI/Sale/Documentation/WSD00001.pdf. 2025
  8. Lane JG. Recurrent laryngeal neuropathy. In: Railton D, editor. Proceedings of the fifteenth Bain‐Fallon memorial lectures. Artarmon: Australian Equine Veterinary Association; 1993. p. 173–192.
  9. Hardwick J, Ahern B, Franklin S. Stakeholder perceptions of yearling sales endoscopy in Australia. Can we do better? Aust Vet J. 2024;102:353–361. https://doi.org/10.1111/avj.13332
  10. Ahern BJ, Sole A, de Klerk K, Hogg LR, Vallance SA, Bertin FR, et al. Evaluation of postsale endoscopy as a predictor of future racing performance in an Australian thoroughbred yearling population. Aust Vet J. 2022;100:254–260. https://doi.org/10.1111/avj.13155
  11. Anderson BH, Hope JJ, Cogger N. Grade 3 left laryngeal movements in young Thoroughbreds do not impair future racing performance. Proc Am Assoc Equine Pract. 2018;64:228.
  12. Hardwick J, Ahern B, Crawford K, et al. Yearling laryngeal function in thoroughbreds that underwent a laryngoplasty differs from controls. Equine Vet J. 2024;1:24–25. https://doi.org/10.1111/evj.14110
  13. Hardwick J, Ahern B, Crawford K, et al. Yearling laryngeal function grades II.2 and below are not associated with reduced future performance. Equine Vet J. 2025;57(4):953–966. https://doi.org/10.1111/evj.14452
  14. Dixon P, Robinson E, Wade JF. Consensus statements on equine recurrent laryngeal neuropathy. Havemeyer Foundation Monograph Series 11. Vol 93. Newmarket: R & W Publications; 2003. Available from: https://havemeyerfoundation.org/wp‐content/uploads/2021/09/monograph11‐Stratford‐Monograph.pdf
  15. Hardwick J, Ahern B, Franklin S. A first step towards objective grading of equine laryngeal function. Vet J. 2024;308:106259. https://doi.org/10.1016/j.tvjl.2024.106259
  16. Arakawa N, Bader LR. Consensus development methods: considerations for national and global frameworks and policy development. Res Soc Admin Pharm. 2022;18(1):2222–2229. https://doi.org/10.1016/j.sapharm.2021.06.024
  17. Nasa P, Jain R, Juneja D. Delphi methodology in healthcare research: how to decide its appropriateness. World J Methodol. 2021;11(4):116–129. https://doi.org/10.5662/wjm.v11.i4.116
  18. Pearson G, Waran N, Reardon RJM, Keen J, Dwyer C. A Delphi study to determine expert consensus on the behavioural indicators of stress in horses undergoing veterinary care. Appl Anim Behav Sci. 2021;237:105291. https://doi.org/10.1016/j.applanim.2021.105291
  19. Wild I, Burford J, England G, et al. Delphi consensus study on the primary assessment of horses with clinical signs of colic. Equine Vet J. 2017;49:14. https://doi.org/10.1111/evj.21_12732
  20. Williams JM, Berg LC, Clayton HM, Kirsch K, Marlin D, Randle H, et al. A Delphi study to determine international and National Equestrian Expert Opinions on domains and sub‐domains essential to managing sporthorse health and welfare in the Olympic disciplines. Animals. 2023;13(21):3404. https://doi.org/10.3390/ani13213404
  21. Bell MA, Cake MA, King LT, Mansfield CF. Identifying the capabilities most important for veterinary employability using a modified Delphi process. Vet Rec. 2022;190(7):e777. https://doi.org/10.1002/vetr.777.
  22. Chalmers J, Armour M. The Delphi technique. In: Liamputtong P, editor. Handbook of research methods in health social sciences. Singapore: Springer; 2019. p. 715–735. https://doi.org/10.1007/978-981-10-5251-4_99
  23. Gattrell WT, Logullo P, van Zuuren EJ, Price A, Hughes EL, Blazey P, et al. ACCORD (ACcurate COnsensus Reporting Document): a reporting guideline for consensus methods in biomedicine developed via a modified Delphi. PLoS Med. 2024;21(1):e1004326. https://doi.org/10.1371/journal.pmed.1004326
  24. Braun V, Clarke V. Successful qualitative research. London: Sage Publications; 2013.
  25. Jünger S, Payne SA, Brine J, Radbruch L, Brearley SG. Guidance on conducting and REporting DElphi Studies (CREDES) in palliative care: recommendations based on a methodological systematic review. Palliat Med. 2017;31(8):684–706. https://doi.org/10.1177/0269216317690685
  26. Schifano J, Niederberger M. How Delphi studies in the health sciences find consensus: a scoping review. Syst Rev. 2025;14(1):14. https://doi.org/10.1186/s13643-024-02738-3
  27. Argue BJ, Ahern BJ. Evaluation of agreement for radiographic lesions and risk for racing in thoroughbred yearling sale repository radiographs. Front Vet Sci. 2024;11:1430993. https://doi.org/10.3389/fvets.2024.1430993
  28. Morrell L, Lovett J. New grading system announced. Rutherford: Australian Bloodstock; 2024 [cited 2025 Aug 19]. Available from: https://www.australianbloodstock.com.au/new-grading-system-announced
  29. Hackett RP, Ducharme NG, Fubini SL, et al. The reliability of endoscopic examination in assessment of arytenoid cartilage movement in horses. Part 1: subjective and objective laryngeal evaluation. Vet Surg. 1991;20:174–179. https://doi.org/10.1111/j.1532-950X.1991.tb00331.x
  30. Perkins JD, Salz RO, Schumacher J, et al. Variability of resting endoscopic grading for assessment of recurrent laryngeal neuropathy in horses. Equine Vet J. 2009;41:342–346. https://doi.org/10.2746/042516409X423073
  31. McLellan J, Plevin S. Evaluation of videoendoscopic examinations of arytenoid function in the 2‐year‐old Thoroughbred: can we all agree? Equine Vet J. 2019;51:364–369. https://doi.org/10.1111/evj.13030
  32. CL MG, Sweeney J, David F, et al. Intra‐ and interobserver reliability estimates for identification and grading of upper respiratory tract abnormalities recorded in horses at rest and during overground endoscopy. Equine Vet J. 2017;49:433–437. https://doi.org/10.1111/evj.12653
  33. Garrett KS, Pierce SW, Embertson RM, et al. Endoscopic evaluation of arytenoid function and epiglottic structure in Thoroughbred yearlings and association with racing performance at two to four years of age: 2,954 cases (1998–2001). J Am Vet Med Assoc. 2010;236:669–673. https://doi.org/10.2460/javma.236.6.66934
  34. Ducharme NG, Hackett RP, Fubini SL, et al. The reliability of endoscopic examination in assessment of arytenoid cartilage movement in horses. Part II. Influence of side of examination, reexamination, and sedation. Vet Surg. 1991;20:180. https://doi.org/10.1111/j.1532-950x.1991.tb00332.x
  35. Racing Australia Fact Book. 2024 [cited 2025 Nov 20]. Available from: https://publishingservices.racingaustralia.horse/Newsletters/2024_Racing_Australia_Fact_Book/.
  36. Thoroughbred Breeders of Australia. Our industry. Available from: https://www.tbaus.com/australian-breeding/our-industry/

Citations

This article has been cited 0 times.
Subscribe to our newsletter
Join 100,280 horse owners like you who receive our email updates on horse health and nutrition.