Comparison of three acute colic pain scales: Reliability, validity and usability

Area of Science:

• Veterinary Medicine
• Animal Health
• Equine Science

Background:

• Accurate assessment of acute abdominal pain severity in horses is crucial for timely and effective treatment.
• Existing pain scales vary in reliability and usability, necessitating a validated tool for equine colic cases.

Purpose of the Study:

• To compare the reliability and usability of three scales for assessing acute abdominal pain in horses: the equine acute abdominal pain scale (EAAPS), the Mair and Smith (M and S) scale, and a numerical rating scale (NRS).

Main Methods:

• Forty films of horses (35 colic, 5 control) were evaluated by 46 equine veterinarians using one of the three scales.
• Inter-observer and intra-observer reliability were assessed using intraclass correlation (ICC) and weighted kappa.
• Usability, speed, and face validity were evaluated through expert opinion and response rates.

Main Results:

• The EAAPS exhibited significantly higher inter-observer reliability (ICC=0.86) and intra-observer reliability (κ=0.95) compared to the M and S (ICC=0.68, κ=0.78) and NRS (ICC=0.71, κ=0.77) scales.
• No significant differences were found in other validity measures (convergent, extreme group, predictive) or usability (speed, ease of use).
• The M and S scale demonstrated better face validity than the EAAPS.

Conclusions:

• The EAAPS is a highly reliable tool for assessing acute abdominal pain severity in horses, outperforming the M and S and NRS scales in consistency among observers.
• While the M and S scale has superior face validity, the EAAPS's enhanced reliability makes it a valuable instrument for clinical use in equine colic assessment.