Objective assessment of acute pain in foals using a facial expression-based pain scale

IF 2.2 2区农林科学 Q1 VETERINARY SCIENCES Equine Veterinary Journal Pub Date : 2025-01-30 DOI:10.1111/evj.14481

Johannes P. A. M. van Loon, Pedro Henrique Esteves Trindade, Gustavo Venâncio da Silva, Jiska Keus, Carlijn Huberts, Janny C. de Grauw, Aliai Lanci

{"title":"Objective assessment of acute pain in foals using a facial expression-based pain scale","authors":"Johannes P. A. M. van Loon, Pedro Henrique Esteves Trindade, Gustavo Venâncio da Silva, Jiska Keus, Carlijn Huberts, Janny C. de Grauw, Aliai Lanci","doi":"10.1111/evj.14481","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Pain assessment based on facial expressions has been described in foals.</p>\n </section>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>To extend previous pilot findings of the Equine Utrecht University Scale for Facial Assessment of Pain in Foals (EQUUS-FAP FOAL).</p>\n </section>\n \n <section>\n \n <h3> Study design</h3>\n \n <p>Prospective blinded case–control study (known groups analysis).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Video recordings (30–60 s) of <i>n</i> = 100 foals (38 patients and 62 controls) were collected. Videos were randomised and scored by two observers, blinded for the condition of the animals. Inter- and intra-observer agreement was tested by Intra Class Correlation (ICC) analysis. Differences between patients and controls were tested using Mann–Whitney <i>U</i> test, differences before and after analgesic treatment were tested with Wilcoxon signed rank test. Multilevel binomial logistic regression was performed for statistical weighting of each pain scale item. Receiver operating characteristic (ROC) analysis was performed to determine sensitivity, specificity and cut-off values.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>EQUUS-FAP FOAL showed good inter- and intra-observer reliability (ICC coefficient of 0.85 and 0.90 respectively, <i>p</i> < 0.001). Patients had significantly higher pain scores (median score 7, IQR 5.3–7.5) compared with controls (median score 2.5, IQR 1–3, <i>p</i> < 0.001) and the patient pain scores decreased after analgesic treatment (median score 6.5, IQR 5–8 vs. median score 4.5, IQR 3.5–6.5, <i>p</i> < 0.05). Multilevel binomial logistic regression showed the relative importance of the individual scale items. Using the original scale, sensitivity and specificity were 88.2% (95% CI 76%–96%) and 87.9% (81%–98%) respectively, with an area under the ROC curve of 94.9% (92%–98%), based on a cut-off value of ≥4. These values remained similar with the weighted scale based on logistic regression output.</p>\n </section>\n \n <section>\n \n <h3> Main limitations</h3>\n \n <p>Videos of included patients were short and acquired by a person in front of the stable.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The current study shows that EQUUS-FAP FOAL can be effectively used to assess acute pain in young foals.</p>\n </section>\n </div>","PeriodicalId":11796,"journal":{"name":"Equine Veterinary Journal","volume":"57 6","pages":"1520-1530"},"PeriodicalIF":2.2000,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://beva.onlinelibrary.wiley.com/doi/epdf/10.1111/evj.14481","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Equine Veterinary Journal","FirstCategoryId":"97","ListUrlMain":"https://beva.onlinelibrary.wiley.com/doi/10.1111/evj.14481","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Pain assessment based on facial expressions has been described in foals.

Objectives

To extend previous pilot findings of the Equine Utrecht University Scale for Facial Assessment of Pain in Foals (EQUUS-FAP FOAL).

Study design

Prospective blinded case–control study (known groups analysis).

Methods

Video recordings (30–60 s) of n = 100 foals (38 patients and 62 controls) were collected. Videos were randomised and scored by two observers, blinded for the condition of the animals. Inter- and intra-observer agreement was tested by Intra Class Correlation (ICC) analysis. Differences between patients and controls were tested using Mann–Whitney U test, differences before and after analgesic treatment were tested with Wilcoxon signed rank test. Multilevel binomial logistic regression was performed for statistical weighting of each pain scale item. Receiver operating characteristic (ROC) analysis was performed to determine sensitivity, specificity and cut-off values.

Results

EQUUS-FAP FOAL showed good inter- and intra-observer reliability (ICC coefficient of 0.85 and 0.90 respectively, p < 0.001). Patients had significantly higher pain scores (median score 7, IQR 5.3–7.5) compared with controls (median score 2.5, IQR 1–3, p < 0.001) and the patient pain scores decreased after analgesic treatment (median score 6.5, IQR 5–8 vs. median score 4.5, IQR 3.5–6.5, p < 0.05). Multilevel binomial logistic regression showed the relative importance of the individual scale items. Using the original scale, sensitivity and specificity were 88.2% (95% CI 76%–96%) and 87.9% (81%–98%) respectively, with an area under the ROC curve of 94.9% (92%–98%), based on a cut-off value of ≥4. These values remained similar with the weighted scale based on logistic regression output.

Main limitations

Videos of included patients were short and acquired by a person in front of the stable.

Conclusions

The current study shows that EQUUS-FAP FOAL can be effectively used to assess acute pain in young foals.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

基于面部表情的疼痛量表对马驹急性疼痛的客观评价。

背景：基于面部表情的疼痛评估已经在马驹中被描述过。目的：扩展马乌得勒支大学马驹面部疼痛评估量表（EQUUS-FAP FOAL）的先前试点发现。研究设计：前瞻性盲法病例对照研究（已知组分析）。方法：采集n = 100匹马驹（38例患者和62例对照组）30 ~ 60 s的录像。视频是随机的，并由两名观察者打分，他们对动物的状况一无所知。通过类内相关（ICC）分析来检验观察者之间和观察者内部的一致性。患者与对照组的差异采用Mann-Whitney U检验，镇痛治疗前后的差异采用Wilcoxon sign rank检验。采用多水平二项logistic回归对疼痛量表各条目进行统计加权。进行受试者工作特征（ROC）分析以确定敏感性、特异性和截止值。结果：EQUUS-FAP FOAL表现出良好的观察者间和观察者内信度（ICC系数分别为0.85和0.90）。主要限制：纳入患者的视频较短，由马厩前的人获得。结论：目前的研究表明，EQUUS-FAP FOAL可以有效地用于评估小马驹的急性疼痛。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Equine Veterinary Journal 农林科学-兽医学

CiteScore

5.10

自引率

13.60%

发文量

161

审稿时长

6-16 weeks

期刊介绍： Equine Veterinary Journal publishes evidence to improve clinical practice or expand scientific knowledge underpinning equine veterinary medicine. This unrivalled international scientific journal is published 6 times per year, containing peer-reviewed articles with original and potentially important findings. Contributions are received from sources worldwide.