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Home / Equine Research Bank / J Vet Intern Med / Rater agreement on gait assessment during neurologic examina...
Journal of veterinary internal medicine2014; 28(2); 630-638; doi: 10.1111/jvim.12320

Rater agreement on gait assessment during neurologic examination of horses.

Abstract: Reproducible and accurate recognition of presence and severity of ataxia in horses with neurologic disease is important when establishing a diagnosis, assessing response to treatment, and making recommendations that might influence rider safety or a decision for euthanasia. Objective: To determine the reproducibility and validity of the gait assessment component in the neurologic examination of horses. Methods: Twenty-five horses referred to the Royal Veterinary College Equine Referral Hospital for neurological assessment (n = 15), purchased (without a history of gait abnormalities) for an unrelated study (n = 5), or donated because of perceived ataxia (n = 5). Methods: Utilizing a prospective study design; a group of board-certified medicine (n = 2) and surgery (n = 2) clinicians and residents (n = 2) assessed components of the equine neurologic examination (live and video recorded) and assigned individual and overall neurologic gait deficit grades (0-4). Inter-rater agreement and assessment-reassessment reliability were quantified using intraclass correlation coefficients (ICC). Results: The ICCs of the selected components of the neurologic examination ranged from 0 to 0.69. "Backing up" and "recognition of mistakes over obstacle" were the only components with an ICC > 0.6. Assessment-reassessment agreement was poor to fair. The agreement on gait grading was good overall (ICC = 0.74), but poor for grades ≤ 1 (ICC = 0.08) and fair for ataxia grades ≥ 2 (ICC = 0.43). Clinicians with prior knowledge of a possible gait abnormality were more likely to assign a grade higher than the median grade. Conclusions: Clinicians should be aware of poor agreement even between skilled observers of equine gait abnormalities, especially when the clinical signs are subtle.
Copyright © 2014 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of American College of Veterinary Internal Medicine.
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Publication Date: 2014-02-24 PubMed ID: 24612411PubMed Central: PMC4857973DOI: 10.1111/jvim.12320Google Scholar: Lookup
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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.

The research article investigates the consistency and validity of the gait assessment component of the neurologic examination in horses. It highlights the degree of variation in clinical observation among veterinarians and points out that clinicians having prior knowledge of a possible gait abnormality are more likely to assign a higher grade.

Objective and Methods

  • The objective of this study was to quantify the accuracy and consistency of the gait score assigned to horses during a neurological examination, considering its important role in diagnosis, treatment response assessment, and decision-making associated with rider safety or euthanasia.
  • The authors used a prospective study design and involved a total of 25 horses which were referred for neurological assessment, purchased for an unrelated study, or donated due to suspected ataxia.
  • The equine neurologic examination components were evaluated by a team of six board-certified clinicians (medicine and surgery) and residents, who allocated individual and overall neurologic gait deficit grades ranging from 0 to 4.
  • The evaluations were performed live and also using video recorded assessments and the degree of agreement between different raters and reliability of repeated evaluations were measured using the intraclass correlation coefficient (ICC).

Results

  • The evaluation findings showed a varying degree of agreement with ICCs for different components of the neurologic examination ranging from 0 to 0.69, where the higher the ICC, the greater the agreement amongst raters.
  • Within all the components studied, only ‘Backing up’ and ‘recognition of mistakes over obstacle’ had a fairly good agreement with ICC more than 0.6.
  • The consistency of repeated evaluations (assessment-reassessment reliability) was generally poor to fair.
  • While the overall agreement on gait grading was good (ICC = 0.74), the agreement was poor for lower grade scores (≤ 1, ICC = 0.08) and fair for higher ataxia grade scores (≥ 2, ICC = 0.43).
  • The study also identified a bias where clinicians aware of a potential gait abnormality were inclined to allocate a higher grade than the median.

Conclusion

  • The research concluded that even among skilled veterinarians, agreement on equine gait abnormalities is inconsistently poor, particularly in cases where clinical signs are not very noticeable.
  • The study advocates for increased awareness among clinicians regarding this issue to enhance the validity and reliability of equine neurologic examinations.

Cite This Article

APA
Olsen E, Dunkel B, Barker WH, Finding EJ, Perkins JD, Witte TH, Yates LJ, Andersen PH, Baiker K, Piercy RJ. (2014). Rater agreement on gait assessment during neurologic examination of horses. J Vet Intern Med, 28(2), 630-638. https://doi.org/10.1111/jvim.12320

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 28
Issue: 2
Pages: 630-638

Researcher Affiliations

Olsen, E
  • Department of Large Animals Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark; Department of Clinical Sciences and Services, The Royal Veterinary College, London, UK; Structure & Motion Laboratory, The Royal Veterinary College, London, UK.
Dunkel, B
    Barker, W H J
      Finding, E J T
        Perkins, J D
          Witte, T H
            Yates, L J
              Andersen, P H
                Baiker, K
                  Piercy, R J

                    MeSH Terms

                    • Animals
                    • Ataxia / diagnosis
                    • Ataxia / veterinary
                    • Female
                    • Gait
                    • Horse Diseases / diagnosis
                    • Horses
                    • Male
                    • Nervous System Diseases / diagnosis
                    • Nervous System Diseases / veterinary
                    • Observer Variation
                    • Physical Examination / methods
                    • Physical Examination / standards
                    • Physical Examination / veterinary
                    • Reproducibility of Results
                    • Video Recording

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