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Acta veterinaria Scandinavica2018; 60(1); 24; doi: 10.1186/s13028-018-0377-5

Diagnostic accuracy of blood sucrose as a screening test for equine gastric ulcer syndrome (EGUS) in weanling foals.

Abstract: Equine gastric ulcer syndrome is an important cause of morbidity in weanling foals. Many foals are asymptomatic, and the development of an inexpensive screening test to ensure an early diagnosis is desirable. The objective of this study was to determine the diagnostic accuracy of blood sucrose for diagnosis of EGUS in weanling foals. Results: 45 foals were studied 7 days before and 14 days after weaning. The diagnostic accuracy of blood sucrose for diagnosis of gastric lesions (GL); glandular lesions (GDL); squamous lesions (SQL) and clinically significant gastric lesions (CSL) at 45 and 90 min after administration of 1 g/kg of sucrose via nasogastric intubation was assessed using ROC curves and calculating the AUC. For each lesion type, sucrose concentration in blood was compared to gastroscopy; and sensitivities (Se) and specificities (Sp) were calculated across a range of sucrose concentrations. Cut-off values were selected manually to optimize Se. Because of concerns over the validity of the gold standard, additional Se, Sp, and lesion prevalence data were subsequently estimated and compared using Bayesian latent class analysis. Using the frequentist approach, the prevalence of GL; GDL; SQL and CSL before weaning was 21; 9; 7 and 8% respectively; and increased to 98; 59; 97 and 82% respectively after weaning. At the selected cut-off, Se ranged from 84 to 95% and Sp ranged from 47 to 71%, depending upon the lesion type and time of sampling. In comparison, estimates of Se and Sp were consistently higher when using a Bayesian approach, with Se ranging from 81 to 97%; and Sp ranging from 77 to 97%, depending upon the lesion type and time of sampling. Conclusions: Blood sucrose is a sensitive test for detecting EGUS in weanling foals. Due to its poor specificity, it is not expected that the sucrose blood test will replace gastroscopy, however it may represent a clinically useful screening test to identify foals that may benefit from gastroscopy. Bayesian latent class analysis represents an alternative method to evaluate the diagnostic accuracy of the blood sucrose test in an attempt to avoid bias associated with the assumption that gastroscopy is a perfect test.
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Publication Date: 2018-04-13 PubMed ID: 29653546PubMed Central: PMC5899374DOI: 10.1186/s13028-018-0377-5Google Scholar: Lookup
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  • Comparative Study
  • 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.

This research aimed to assess the diagnostic accuracy of a blood sucrose test as a way to screen for equine gastric ulcer syndrome (EGUS) in young foals. The study found promising evidence that blood sucrose testing could serve as a beneficial preliminary screening method for foals, although its specificity was poor, meaning it may not replace gastroscopy but could help identify foals in need of further testing.

Study Objective and Methodology

  • The main aim of this research was to determine the diagnostic accuracy of using a blood sucrose test to diagnose EGUS in weanling foals.
  • The experiment involved 45 foals who were examined 7 days before and 14 days after weaning.
  • To carry out the testing, each foal was given 1 g/kg sucrose via a nasogastric tube, and the sucrose concentration in the blood was assessed 45 and 90 minutes after administration.
  • The outcomes – gastric, glandular, squamous lesions, and clinically significant gastric lesions – were compared with gastroscopy results, which is the standard diagnostic method for EGUS.

Findings

  • Before weaning, the prevalence of gastric, glandular, squamous, and clinically significant gastric lesions was relatively low. However, after weaning, these numbers dramatically increased.
  • When selecting a cut-off, sensitivity (Se), the ability of the test to correctly identify positives, ranged from 84-95%, whereas specificity (Sp), the ability of the test to correctly identify negatives, ranged 47-71% depending on lesion type and time of sampling.
  • This low specificity suggests that while the blood sucrose test can detect EGUS effectively, it may have a higher chance of false-positive results, indicating the presence of the disease when it isn’t there.
  • The blood sucrose test’s accuracy was also evaluated using a Bayesian approach, resulting in consistently higher estimates of Se and Sp, ranging from 81-97% and 77-97% respectively depending on the lesion type and time of sampling.

Conclusions and Implications

  • Overall, the researchers found that blood sucrose is a sensitive test for detecting EGUS in weanling foals.
  • Due to its relatively poor specificity, it is not expected that the blood sucrose test will completely replace gastroscopy. However, it may serve as a useful screening tool to identify foals that could benefit from gastroscopy.
  • The researchers suggested that the Bayesian latent class analysis is an alternative method to assess the diagnostic accuracy of the test. This can help in avoiding bias linked to the assumption that gastroscopy always provides 100% accurate results.

Cite This Article

APA
Hewetson M, Venner M, Volquardsen J, Sykes BW, Hallowell GD, Vervuert I, Fosgate GT, Tulamo RM. (2018). Diagnostic accuracy of blood sucrose as a screening test for equine gastric ulcer syndrome (EGUS) in weanling foals. Acta Vet Scand, 60(1), 24. https://doi.org/10.1186/s13028-018-0377-5

Publication

Acta veterinaria Scandinavica
ISSN: 1751-0147
NlmUniqueID: 0370400
Country: England
Language: English
Volume: 60
Issue: 1
Pages: 24

Researcher Affiliations

Hewetson, Michael
  • Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland. mhewetson@rvc.ac.uk.
  • The Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA, UK. mhewetson@rvc.ac.uk.
Venner, Monica
  • Equine Clinique, Destedt, Germany.
Volquardsen, Jan
  • Equine Clinique, Destedt, Germany.
Sykes, Ben William
  • School of Veterinary Sciences, University of Queensland, Brisbane, Australia.
Hallowell, Gayle Davina
  • School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK.
Vervuert, Ingrid
  • Institute of Animal Nutrition, Nutrition Diseases and Dietetics, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany.
Fosgate, Geoffrey Theodore
  • Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa.
Tulamo, Riitta-Mari
  • Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.

MeSH Terms

  • Animals
  • Bayes Theorem
  • Female
  • Gastroscopy / methods
  • Gastroscopy / veterinary
  • Horse Diseases / diagnosis
  • Horses
  • Male
  • Mass Screening / methods
  • Mass Screening / veterinary
  • Prevalence
  • Sensitivity and Specificity
  • Stomach Ulcer / diagnosis
  • Stomach Ulcer / veterinary
  • Sucrose / blood

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