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Veterinary dermatology2025; doi: 10.1111/vde.13358

Validation of the Equine Urticaria Activity Score for the assessment of chronic recurrent urticaria in horses.

Abstract: Recurrent urticaria is common in horses. The pathophysiology is poorly understood and treatment options are limited. Often, only glucocorticoids are effective for controlling clinical signs, albeit with potential adverse effects. Studies investigating new treatments need a validated objective scoring system for the grading of skin lesions to assess response. Objective: The aims were to investigate inter- and intraobserver reliability of the Equine Urticaria Activity Score (EqUAS) for the grading of skin lesions in horses with recurrent urticaria, and to examine agreement between experienced and inexperienced observers. Methods: Forty privately owned horses enrolled in a therapeutic clinical trial. Methods: Ten standardised photographs of both sides of the body of each horse were used to create 40 individual datasets. Five masked observers graded the photographs according to the EqUAS for calculation of interobserver reliability. Intraobserver reliability was calculated from two observers each grading the photographs twice. Scores were evaluated for reliability with Pearson's correlation (r) and for agreement with the intraclass correlation coefficient (ICC). Results: Interobserver reliability was excellent with r = 0.9036-0.9600 (p < 0.0001). Intraobserver reliability and agreement also were excellent with r = 0.98 for each observer (p < 0.0001) and ICC = 0.945. Correlation and agreement between experienced and inexperienced observers were excellent (r = 0.9615 [p < 0.0001] and ICC = 0.941). Conclusions: The EqUAS showed excellent intra- and interobserver reliability for the evaluation of skin lesions of horses with chronic recurrent urticaria. It can be a useful tool in clinical studies.
© 2025 The Author(s). Veterinary Dermatology published by John Wiley & Sons Ltd on behalf of ESVD and ACVD.
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Publication Date: 2025-05-19 PubMed ID: 40384485DOI: 10.1111/vde.13358Google Scholar: Lookup
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Summary

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This research investigates the reliability of the Equine Urticaria Activity Score (EqUAS) for grading skin lesions in horses suffering from chronic recurrent urticaria. After analysis with both experienced and inexperienced observers, the study establishes that EqUAS exhibits excellent intra- and interobserver reliability making it a practical aid in clinical trials.

Research Objective

  • The primary goal of this research was to examine the interobserver and intraobserver reliability of the EqUAS for grading skin lesions in horses with recurrent urticaria.
  • The study also aimed to identify the agreement between experienced and inexperienced observers using the EqUAS.

Methodology

  • The researchers enrolled forty privately owned horses in a therapeutic clinical trial.
  • Ten standardised photographs of each side of the body of each horse were taken. These photographs were used to create 40 individual datasets.
  • Five masked observers graded the photographs according to the EqUAS for the calculation of interobserver reliability.
  • Intraobserver reliability was calculated from two observers each grading the photographs twice.
  • Moreover, to evaluate the reliability and agreement of the scores, researchers used Pearson’s correlation (r) and the intraclass correlation coefficient (ICC).

Results

  • The interobserver reliability was excellent with r ranging from 0.9036 to 0.9600 (p < 0.0001).
  • Intraobserver reliability and agreement also showcased excellent results with r for both observers being 0.98(p < 0.0001) and an ICC of 0.945.
  • The correlation and agreement between experienced and inexperienced observers were also reported to be excellent (r = 0.9615 [p < 0.0001] and ICC = 0.941).

Conclusion

  • The study validates that EqUAS exhibits excellent intra- and interobserver reliability for assessing skin lesions in horses with chronic recurrent urticaria.
  • Thus, this scoring system can potentially be a constructive tool to be used in clinical trials to research new treatments for chronic recurrent urticaria in horses.

Cite This Article

APA
Birkmann K, Waldern N, Jucker S, Balaschitsch K, Zablotski Y, Fettelschoss-Gabriel A. (2025). Validation of the Equine Urticaria Activity Score for the assessment of chronic recurrent urticaria in horses. Vet Dermatol. https://doi.org/10.1111/vde.13358

Publication

Veterinary dermatology
ISSN: 1365-3164
NlmUniqueID: 9426187
Country: England
Language: English

Researcher Affiliations

Birkmann, Katharina
  • Evax AG, Guntershausen, Switzerland.
  • Equine Clinic, Ludwig-Maximilians University Munich, Oberschleißheim, Germany.
Waldern, Nina
  • Evax AG, Guntershausen, Switzerland.
Jucker, Simone
  • Evax AG, Guntershausen, Switzerland.
Balaschitsch, Katharina
  • Evax AG, Guntershausen, Switzerland.
Zablotski, Yury
  • Clinic for Ruminants with Ambulatory and Herd Health Services, Ludwig-Maximilians University Munich, Oberschleißheim, Germany.
Fettelschoss-Gabriel, Antonia
  • Evax AG, Guntershausen, Switzerland.
  • Department of Dermatology, University Hospital Zurich, Zürich, Switzerland.
  • Faculty of Medicine, University of Zurich, Zürich, Switzerland.

Grant Funding

  • Evax AG and the Swiss National Fond (SNF) BRIDGE to AF-G

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