A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses
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A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses. / da Rocha, Paula Barreto; Driessen, Bernd; McDonnell, Sue M.; Hopster, Klaus; Zarucco, Laura; Gozalo-Marcilla, Miguel; Hopster-Iversen, Charlotte; Trindade, Pedro Henrique Esteves; da Rocha, Thamiris Kristine Gonzaga; Taffarel, Marilda Onghero; Alonso, Bruna Bodini; Schauvliege, Stijn; Luna, Stelio Pacca Loureiro.
I: PLoS ONE, Bind 16, Nr. 8, e0255618, 2021.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses
AU - da Rocha, Paula Barreto
AU - Driessen, Bernd
AU - McDonnell, Sue M.
AU - Hopster, Klaus
AU - Zarucco, Laura
AU - Gozalo-Marcilla, Miguel
AU - Hopster-Iversen, Charlotte
AU - Trindade, Pedro Henrique Esteves
AU - da Rocha, Thamiris Kristine Gonzaga
AU - Taffarel, Marilda Onghero
AU - Alonso, Bruna Bodini
AU - Schauvliege, Stijn
AU - Luna, Stelio Pacca Loureiro
N1 - Publisher Copyright: © 2021 Barreto da Rocha et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2021
Y1 - 2021
N2 - Proper pain therapy requires adequate pain assessment. This study evaluated the reliability and validity of the Unesp-Botucatu horse acute pain scale (UHAPS), the Orthopedic Composite Pain Scale (CPS) and unidimensional scales in horses admitted for orthopedic and soft tissue surgery. Forty-two horses were assessed and videotaped before surgery, up to 4 hours postoperatively, up to 3 hours after analgesic treatment, and 24 hours postoperatively (168 video clips). After six evaluators viewing each edited video clip twice in random order at a 20-day interval, they chose whether analgesia would be indicated and applied the Simple Descriptive, Numeric and Visual Analog scales, CPS, and UHAPS. For all evaluators, intraobserver reliability of UHAPS and CPS ranged from 0.70 to 0.97. Reproducibility was variable among the evaluators and ranged from poor to very good for all scales. Principal component analysis showed a weak association among 50% and 62% of the UHAPS and CPS items, respectively. Criterion validity based on Spearman correlation among all scales was above 0.67. Internal consistency was minimally acceptable (0.51-0.64). Item-total correlation was acceptable (0.3-0.7) for 50% and 38% of UHAPS and CPS items, respectively. UHAPS and CPS were specific (90% and 79% respectively), but both were not sensitive (43 and 38%, respectively). Construct validity (responsiveness) was confirmed for all scales because pain scores increased after surgery. The cut-off point for rescue analgesia was ≥ 5 and ≥ 7 for the UHAPS and CPS, respectively. All scales presented adequate repeatability, criterion validity, and partial responsiveness. Both composite scales showed poor association among items, minimally acceptable internal consistency, and weak sensitivity, indicating that they are suboptimal instruments for assessing postoperative pain. Both composite scales require further refinement with the exclusion of redundant or needless items and reduction of their maximum score applied to each item or should be replaced by other tools.
AB - Proper pain therapy requires adequate pain assessment. This study evaluated the reliability and validity of the Unesp-Botucatu horse acute pain scale (UHAPS), the Orthopedic Composite Pain Scale (CPS) and unidimensional scales in horses admitted for orthopedic and soft tissue surgery. Forty-two horses were assessed and videotaped before surgery, up to 4 hours postoperatively, up to 3 hours after analgesic treatment, and 24 hours postoperatively (168 video clips). After six evaluators viewing each edited video clip twice in random order at a 20-day interval, they chose whether analgesia would be indicated and applied the Simple Descriptive, Numeric and Visual Analog scales, CPS, and UHAPS. For all evaluators, intraobserver reliability of UHAPS and CPS ranged from 0.70 to 0.97. Reproducibility was variable among the evaluators and ranged from poor to very good for all scales. Principal component analysis showed a weak association among 50% and 62% of the UHAPS and CPS items, respectively. Criterion validity based on Spearman correlation among all scales was above 0.67. Internal consistency was minimally acceptable (0.51-0.64). Item-total correlation was acceptable (0.3-0.7) for 50% and 38% of UHAPS and CPS items, respectively. UHAPS and CPS were specific (90% and 79% respectively), but both were not sensitive (43 and 38%, respectively). Construct validity (responsiveness) was confirmed for all scales because pain scores increased after surgery. The cut-off point for rescue analgesia was ≥ 5 and ≥ 7 for the UHAPS and CPS, respectively. All scales presented adequate repeatability, criterion validity, and partial responsiveness. Both composite scales showed poor association among items, minimally acceptable internal consistency, and weak sensitivity, indicating that they are suboptimal instruments for assessing postoperative pain. Both composite scales require further refinement with the exclusion of redundant or needless items and reduction of their maximum score applied to each item or should be replaced by other tools.
U2 - 10.1371/journal.pone.0255618
DO - 10.1371/journal.pone.0255618
M3 - Journal article
C2 - 34352001
AN - SCOPUS:85112607499
VL - 16
JO - PLoS ONE
JF - PLoS ONE
SN - 1932-6203
IS - 8
M1 - e0255618
ER -
ID: 276902638