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Equine veterinary journal2005; 37(6); 541-545; doi: 10.2746/042516405775314899

Radiographic scoring lacks predictive value in inflammatory airway disease.

Abstract: Diagnosis of inflammatory airway disease (IAD) currently rests upon the results of bronchoalveolar lavage (BAL) cytology, lung function testing and histamine bronchoprovocation (HBP), none of which provides direct information about structural change in the lung. Objective: That thoracic radiography might better portray structural change in the lungs and therefore offer a good clinical assessment of IAD. Methods: A radiographic scoring system was developed to assess the extent of bronchial and interstitial pattern on thoracic radiographs in the dorsocaudal, dorsocranial and caudoventral regions in 16 control horses and 33 horses with IAD. Mean scores were compared to ascertain whether thoracic radiographs could distinguish between the 2 groups. In order to determine whether independent observers reliably scored radiographs similarly, an inter-rater reliability score was employed for each radiographic observation. Correlations between radiographic scores, BAL cytology, lung function testing using the forced oscillatory technique and HBP were examined. Results: Inter-rater reliability was only moderate. Radiographic scoring demonstrated no differences between the 2 groups. There were no correlations among BAL cytology, lung function testing, HBP and radiographic scores. Conclusions: Thoracic radiographs are a low-yield diagnostic modality in horses with a clinical history compatible with IAD. In the absence of clinical evidence of more extensive, infectious disease, thoracic radiographs neither refine nor improve diagnosis of IAD, but increase diagnostic costs.
Publication Date: 2005-11-22 PubMed ID: 16295932DOI: 10.2746/042516405775314899Google Scholar: Lookup
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  • Journal Article

Summary

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This research explores the efficacy of using thoracic radiographs as a diagnostic tool for inflammatory airway disease (IAD) in horses, concluding that it does not provide reliable results or improvements in the diagnosis process and instead only increases costs.

Research Objective

The objective of this research was to assess if thoracic radiographs could provide a more detailed picture of structural changes in the lungs of horses and thus serve as an improved clinical assessment tool for IAD.

Research Method

  • The researchers designed a scoring system for evaluating the bronchial and interstitial patterns visible on thoracic radiographs. This scoring system was applied to images from 16 control horses and 33 horses diagnosed with IAD.
  • The regions surveyed in the images were dorsocaudal, dorsocranial, and caudoventral.
  • The mean scores for both groups were compared to determine if the radiographic scores could distinguish between horses with IAD and the control group.
  • Inter-rater reliability scores were used to see if different observers scored the radiographs similarly.
  • Further, the researchers compared the correlations between radiographic scores, bronchoalveolar lavage (BAL) cytology, lung function testing, and histamine bronchoprovocation (HBP).

Research Results

  • The reliability of scores between different observers was found to be only moderate, i.e., not highly reliable.
  • Comparison of radiographic scoring did not reveal any significant differences between horses with IAD and control horses.
  • There were no discernable correlations between the parameters evaluated – BAL cytology, lung function testing, HBP, and radiographic scores.

Research Conclusion

Based on the results, the researchers concluded that thoracic radiographs are of low diagnostic value for IAD in horses. In cases where horses show clinical signs compatible with IAD but no evidence of more extensive infectious diseases, using thoracic radiographs neither improves nor refines the diagnosis. Instead, it adds to the diagnostic costs unnecessarily.

Cite This Article

APA
Mazan MR, Vin R, Hoffman AM. (2005). Radiographic scoring lacks predictive value in inflammatory airway disease. Equine Vet J, 37(6), 541-545. https://doi.org/10.2746/042516405775314899

Publication

ISSN: 0425-1644
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 37
Issue: 6
Pages: 541-545

Researcher Affiliations

Mazan, M R
  • Lung Function Laboratory, Tufts University School of Veterinary Medicine, 200 Westboro Road, North Grafton, Massachusetts 01536, USA.
Vin, R
    Hoffman, A M

      MeSH Terms

      • Animals
      • Bronchoalveolar Lavage Fluid / cytology
      • Case-Control Studies
      • Forced Expiratory Flow Rates
      • Horse Diseases / diagnosis
      • Horse Diseases / diagnostic imaging
      • Horses
      • Lung / diagnostic imaging
      • Predictive Value of Tests
      • Radiography, Thoracic / economics
      • Radiography, Thoracic / methods
      • Radiography, Thoracic / veterinary
      • Respiratory Function Tests / veterinary
      • Respiratory Tract Diseases / diagnosis
      • Respiratory Tract Diseases / diagnostic imaging
      • Respiratory Tract Diseases / veterinary
      • Sensitivity and Specificity

      Citations

      This article has been cited 15 times.
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      3. Dixon CE, Bedenice D, Mazan MR. Comparison of Flowmetric Plethysmography and Forced Oscillatory Mechanics to Measure Airway Hyperresponsiveness in Horses. Front Vet Sci 2020;7:511023.
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      15. Robins TJ, Bedenice D, Mazan M. A Longitudinal Analysis of Equine Asthma Presentation and Response to Treatment Using Lung Function Testing and BAL Cytology Analysis in Combination with Owner Perception. Animals (Basel) 2023 Nov 1;13(21).
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