Effects of case definition and assessment frequency on lameness incidence estimates

The reliability of locomotion scoring is often low, making it unclear how a single gait score should be interpreted. In addition, differences in assessment frequency between longitudinal studies makes it hard to compare results. Our aims were to evaluate how lameness definition and assessment frequency affect measures of lameness incidence. Six dairy farms in British Columbia, Canada, were enrolled, and 262 cows that were sound at dry-off had their locomotion score (LS) assessed weekly from dry-off to calving, using a 1 to 5 scale. Cows were categorized as remaining sound or becoming lame using 3 different case definitions (LAME1: ≥LS3 at least once; LAME2: ≥2 consecutive scores of LS3, or ≥LS4 at least once; and LAME3: ≥3 consecutive scores of LS3, or ≥LS4 at least once). We analyzed the correspondence between the 3 definitions with percent agreement and weighted κ (linear and quadratic weighting). Comparing LAME1 to LAME3 resulted in lower percent agreement (53%) and κ values (linear κ_w = 0.50; quadratic κ_w = 0.64) than comparing LAME2 and LAME3 (85%; linear κ_w = 0.83; quadratic κ_w = 0.89), indicating that cows scored LS3 twice were likely to be scored LS3 a third time. We also compared the 3 case definitions against trim records from trimmings occurring 90 d or less before calving (n = 117), and used logistic regression models to determine sensitivity, specificity, and positive and negative predictive value. Using the LAME1 criterion resulted in high sensitivity (horn lesions = 0.90; infectious lesions = 0.92) and low specificity (horn = 0.21; infectious = 0.24). We observed higher specificity for LAME2 (horn = 0.62; infectious = 0.66) and LAME3 (horn = 0.71; infectious = 0.77), but LAME2 had higher sensitivity than LAME3 (horn = 0.89 vs. 0.64; infectious = 0.69 vs. 0.64). When evaluating the effects of assessment frequency, we obtained 3 data sets by keeping every, every other, and every third locomotion assessment, and using LAME2 as a case definition. More cows were categorized as lame when assessment frequency increased. Of the cows that were classified as lame when assessed weekly, 72% of the mildly lame, and 33% of the severely lame were classified as sound when assessed every third week. Our results suggest that a single LS3 score should not be used as a criterion for lameness in longitudinal studies. To correctly identify new cases of lameness, dairy cows should be assessed at least every 2 wk.