A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1371/journal.pone.0255618 http://hdl.handle.net/11449/229337 |
Resumo: | 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. |
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A critical evaluation for validation of composite and unidimensional postoperative pain scales in horsesProper 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.Department of Surgical Specialties and Anesthesiology Medical School São Paulo State University (Unesp), São PauloDepartment of Clinical Studies New Bolton Center School of Veterinary Medicine University of Pennsylvania, Kennett SquareDipartimento di Scienze Veterinarie Università degli Studi di TorinoThe Royal (Dick) School of Veterinary Studies Roslin Institute The University of Edinburgh, MidlothianDepartment of Veterinary Clinical Sciences Section of Medicine and Surgery Faculty of Health and Medical Sciences University of CopenhagenDepartment of Veterinary Surgery and Animal Reproduction School of Veterinary Medicine and Animal Science São Paulo State University (Unesp), São PauloDepartment of Veterinary Medicine MaringáState University, ParanáFaculty of Animal Science and Food Engineering Sao Paulo State UniversityDepartment of Anesthesiology and Domestic Animal Surgery Faculty of Veterinary Medicine Ghent UniversityDepartment of Surgical Specialties and Anesthesiology Medical School São Paulo State University (Unesp), São PauloDepartment of Veterinary Surgery and Animal Reproduction School of Veterinary Medicine and Animal Science São Paulo State University (Unesp), São PauloFaculty of Animal Science and Food Engineering Sao Paulo State UniversityUniversidade Estadual Paulista (UNESP)University of PennsylvaniaUniversità degli Studi di TorinoThe University of EdinburghUniversity of CopenhagenMaringáState UniversityGhent Universityda Rocha, Paula Barreto [UNESP]Driessen, BerndMcDonnell, Sue M.Hopster, KlausZarucco, LauraGozalo-Marcilla, MiguelHopster-Iversen, CharlotteTrindade, Pedro Henrique Esteves [UNESP]da Rocha, Thamiris Kristine Gonzaga [UNESP]Taffarel, Marilda OngheroAlonso, Bruna Bodini [UNESP]Schauvliege, StijnLuna, Stelio Pacca Loureiro [UNESP]2022-04-29T08:32:02Z2022-04-29T08:32:02Z2021-08-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1371/journal.pone.0255618PLoS ONE, v. 16, n. 8 August, 2021.1932-6203http://hdl.handle.net/11449/22933710.1371/journal.pone.02556182-s2.0-85112607499Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengPLoS ONEinfo:eu-repo/semantics/openAccess2022-04-29T08:32:02Zoai:repositorio.unesp.br:11449/229337Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462022-04-29T08:32:02Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses |
title |
A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses |
spellingShingle |
A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses da Rocha, Paula Barreto [UNESP] |
title_short |
A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses |
title_full |
A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses |
title_fullStr |
A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses |
title_full_unstemmed |
A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses |
title_sort |
A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses |
author |
da Rocha, Paula Barreto [UNESP] |
author_facet |
da Rocha, Paula Barreto [UNESP] Driessen, Bernd McDonnell, Sue M. Hopster, Klaus Zarucco, Laura Gozalo-Marcilla, Miguel Hopster-Iversen, Charlotte Trindade, Pedro Henrique Esteves [UNESP] da Rocha, Thamiris Kristine Gonzaga [UNESP] Taffarel, Marilda Onghero Alonso, Bruna Bodini [UNESP] Schauvliege, Stijn Luna, Stelio Pacca Loureiro [UNESP] |
author_role |
author |
author2 |
Driessen, Bernd McDonnell, Sue M. Hopster, Klaus Zarucco, Laura Gozalo-Marcilla, Miguel Hopster-Iversen, Charlotte Trindade, Pedro Henrique Esteves [UNESP] da Rocha, Thamiris Kristine Gonzaga [UNESP] Taffarel, Marilda Onghero Alonso, Bruna Bodini [UNESP] Schauvliege, Stijn Luna, Stelio Pacca Loureiro [UNESP] |
author2_role |
author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Estadual Paulista (UNESP) University of Pennsylvania Università degli Studi di Torino The University of Edinburgh University of Copenhagen MaringáState University Ghent University |
dc.contributor.author.fl_str_mv |
da Rocha, Paula Barreto [UNESP] Driessen, Bernd McDonnell, Sue M. Hopster, Klaus Zarucco, Laura Gozalo-Marcilla, Miguel Hopster-Iversen, Charlotte Trindade, Pedro Henrique Esteves [UNESP] da Rocha, Thamiris Kristine Gonzaga [UNESP] Taffarel, Marilda Onghero Alonso, Bruna Bodini [UNESP] Schauvliege, Stijn Luna, Stelio Pacca Loureiro [UNESP] |
description |
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. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-08-01 2022-04-29T08:32:02Z 2022-04-29T08:32:02Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1371/journal.pone.0255618 PLoS ONE, v. 16, n. 8 August, 2021. 1932-6203 http://hdl.handle.net/11449/229337 10.1371/journal.pone.0255618 2-s2.0-85112607499 |
url |
http://dx.doi.org/10.1371/journal.pone.0255618 http://hdl.handle.net/11449/229337 |
identifier_str_mv |
PLoS ONE, v. 16, n. 8 August, 2021. 1932-6203 10.1371/journal.pone.0255618 2-s2.0-85112607499 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
PLoS ONE |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
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1799965597582229504 |