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Equine veterinary journal2023; doi: 10.1111/evj.13986

History, Rest and Exercise Score (HRE-S) for assessment of disease severity in horses with trigeminal-mediated headshaking.

Abstract: In horses with trigeminal-mediated headshaking (TMHS), clinical signs are likely to be expression of neuropathic facial pain. Currently, subjective assessment of disease severity is used as measure of compromise of animal's welfare. Objective: To develop and validate a precise scoring system for TMHS: History, Rest and Exercise Score (HRE-S). The HRE-S consists of three subscores: history score (H-S), resting score (R-S) and exercise score (E-S). Methods: Retrospective observational study. Methods: Seven masked observers with different experience used HRE-S to score 40 video recordings taken during rest and lungeing including five duplicates. Video recordings were taken from nine horses with TMHS and three controls. Inter- and intraobserver reliability and practicability of HRE-S were assessed. For every video recording severity of clinical signs was graded by every observer using an intuitive global-type-scale and interobserver reliability was calculated. Convergent validity was evaluated comparing HRE-S to groups created by an existing score (grade 0-3). Discriminant validity was analysed comparing HRE-S to groups created by intuitive global-type-scale. Results: Reliability for HRE-S was excellent, irrespective of observers experience: Spearman's Rho = 0.946, p < 0.001 (intraobserver reliability) and intraclass correlation coefficient = 0.98, p < 0.001 (interobserver reliability). Interobserver reliability for intuitive global-type-scale was fair to substantial: Fleiss' κappa = 0.48 (R-S) -0.63 (E-S). Groups created by intuitive global-type-scale had significantly different R-S and E-S (p < 0.05), demonstrating discriminant validity. Convergent validity was proven as horses with grade 3/3 had significantly higher average E-S and total scores compared with an existing score than those with grade 0/3 or 1/3 (p < 0.001). Conclusions: Retrospective nature, video recordings, sample size. Conclusions: HRE-S is a valid and reliable score evaluating disease severity in TMHS, independent of observers' experience.
Publication Date: 2023-08-22 PubMed ID: 37608443DOI: 10.1111/evj.13986Google Scholar: Lookup
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  • Journal Article

Summary

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The research article focuses on the development and validation of a new scoring system called History, Rest and Exercise Score (HRE-S) for the assessment of disease severity in horses with trigeminal-mediated headshaking (TMHS).

Objective of the Study

  • The primary aim of the research was to create and validate a precise scoring system—HRE-S—for assessing the severity of TMHS in horses.

Method of the Study

  • The study was a retrospective observational study that involved seven observers who evaluated 40 video recordings of horses, which also included five duplicates.
  • These recordings featuring nine horses with TMHS and three controls were made during rest and lungeing.
  • To test the reliability of HRE-S, both inter- and intraobserver reliability and practicability were examined through statistical computations.
  • The researchers also used an intuitive global-type-scale to grade the severity of the clinical signs in each video recording and determined the interobserver reliability here.
  • They pursued two types of validations—Convergent and Discriminant. The former compared HRE-S with groups formed via an existing score (grades 0-3), while the latter contrasted HRE-S with groups devised by the intuitive global-type-scale.

Results of the Study

  • The findings confirmed the high reliability of HRE-S, irrespective of observers’ experience. This was established through Spearman’s Rho for intraobserver reliability and the intraclass correlation coefficient for interobserver reliability.
  • Meanwhile, the interobserver reliability for the intuitive global-type-scale was found to range from fair to substantial. This was ascertained via Fleiss’s kappa.
  • Demonstrating the discriminant validity of HRE-S, the study found significant differences in the resting and exercise scores among groups formed by the intuitive global-type-scale.
  • The convergent validity was validated since the horses with the maximum grade (3/3) had significantly higher average exercise scores and total scores when compared with the existing system than those with grade 0/3 or 1/3.

Conclusions of the Study

  • Despite the retrospective nature of the study and the limited sample size, the research established HRE-S as a valid and highly reliable scoring system for evaluating TMHS severity, regardless of an observer’s experience.

Cite This Article

APA
Kloock T, Pickles KJ, Roberts V, Uhlendorf F, Twele L, Wilkens HL, Stehle E, Feige K, Niebuhr T. (2023). History, Rest and Exercise Score (HRE-S) for assessment of disease severity in horses with trigeminal-mediated headshaking. Equine Vet J. https://doi.org/10.1111/evj.13986

Publication

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

Researcher Affiliations

Kloock, Tanja
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany.
Pickles, Kirstie J
  • School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK.
Roberts, Veronica
  • Bristol Veterinary School, University of Bristol, Bristol, UK.
Uhlendorf, Frauke
  • IDEXX Med Labor GmbH, Kornwestheim, Germany.
Twele, Lara
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany.
Wilkens, Henriette L
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany.
Stehle, Eva
  • Celle, Germany.
Feige, Karsten
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany.
Niebuhr, Tobias
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany.

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