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A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses

dc.contributor.authorda Rocha, Paula Barreto [UNESP]
dc.contributor.authorDriessen, Bernd
dc.contributor.authorMcDonnell, Sue M.
dc.contributor.authorHopster, Klaus
dc.contributor.authorZarucco, Laura
dc.contributor.authorGozalo-Marcilla, Miguel
dc.contributor.authorHopster-Iversen, Charlotte
dc.contributor.authorTrindade, Pedro Henrique Esteves [UNESP]
dc.contributor.authorda Rocha, Thamiris Kristine Gonzaga [UNESP]
dc.contributor.authorTaffarel, Marilda Onghero
dc.contributor.authorAlonso, Bruna Bodini [UNESP]
dc.contributor.authorSchauvliege, Stijn
dc.contributor.authorLuna, Stelio Pacca Loureiro [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionUniversity of Pennsylvania
dc.contributor.institutionUniversità degli Studi di Torino
dc.contributor.institutionThe University of Edinburgh
dc.contributor.institutionUniversity of Copenhagen
dc.contributor.institutionMaringáState University
dc.contributor.institutionGhent University
dc.date.accessioned2022-04-29T08:32:02Z
dc.date.available2022-04-29T08:32:02Z
dc.date.issued2021-08-01
dc.description.abstractProper 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.en
dc.description.affiliationDepartment of Surgical Specialties and Anesthesiology Medical School São Paulo State University (Unesp), São Paulo
dc.description.affiliationDepartment of Clinical Studies New Bolton Center School of Veterinary Medicine University of Pennsylvania, Kennett Square
dc.description.affiliationDipartimento di Scienze Veterinarie Università degli Studi di Torino
dc.description.affiliationThe Royal (Dick) School of Veterinary Studies Roslin Institute The University of Edinburgh, Midlothian
dc.description.affiliationDepartment of Veterinary Clinical Sciences Section of Medicine and Surgery Faculty of Health and Medical Sciences University of Copenhagen
dc.description.affiliationDepartment of Veterinary Surgery and Animal Reproduction School of Veterinary Medicine and Animal Science São Paulo State University (Unesp), São Paulo
dc.description.affiliationDepartment of Veterinary Medicine MaringáState University, Paraná
dc.description.affiliationFaculty of Animal Science and Food Engineering Sao Paulo State University
dc.description.affiliationDepartment of Anesthesiology and Domestic Animal Surgery Faculty of Veterinary Medicine Ghent University
dc.description.affiliationUnespDepartment of Surgical Specialties and Anesthesiology Medical School São Paulo State University (Unesp), São Paulo
dc.description.affiliationUnespDepartment of Veterinary Surgery and Animal Reproduction School of Veterinary Medicine and Animal Science São Paulo State University (Unesp), São Paulo
dc.description.affiliationUnespFaculty of Animal Science and Food Engineering Sao Paulo State University
dc.identifierhttp://dx.doi.org/10.1371/journal.pone.0255618
dc.identifier.citationPLoS ONE, v. 16, n. 8 August, 2021.
dc.identifier.doi10.1371/journal.pone.0255618
dc.identifier.issn1932-6203
dc.identifier.scopus2-s2.0-85112607499
dc.identifier.urihttp://hdl.handle.net/11449/229337
dc.language.isoeng
dc.relation.ispartofPLoS ONE
dc.sourceScopus
dc.titleA critical evaluation for validation of composite and unidimensional postoperative pain scales in horsesen
dc.typeArtigo
dspace.entity.typePublication
unesp.campusUniversidade Estadual Paulista (UNESP), Faculdade de Medicina Veterinária e Zootecnia, Botucatupt
unesp.departmentReprodução Animal e Radiologia Veterinária - FMVZpt

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