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A comparison of four systems for scoring recovery quality after general anaesthesia in horses

Authors

  • E. VETTORATO,

    Corresponding author
      Email: enzovetto@libero.it
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  • M. E. CHASE-TOPPING,

    1. Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Midlothian; and Centre for Infectious Diseases, Ashworth Laboratories, Kings Buildings, The University of Edinburgh, UK.
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  • R. E. CLUTTON

    1. Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Midlothian; and Centre for Infectious Diseases, Ashworth Laboratories, Kings Buildings, The University of Edinburgh, UK.
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Email: enzovetto@libero.it

Summary

Reason for performing study: The recovery quality scoring systems (RQSSs) in current use have not been critically reviewed for reliability.

Objective: To examine reliability (reproducibility) of 4 RQSSs when applied to a ranked series.

Methods: A DVD incorporating the recordings of 9 horses recovering from general anaesthesia was evaluated by final year students over 5 days. On Day 1, each evaluator ranked recoveries from 1–9 (1 = best). Over the following 4 days, each evaluator scored the same recoveries using 4 different RQSSs (3 of them in common usage and previously published) applied in random order. The scores from each RQSS were ranked and plotted against the Day 1 ranking of each evaluator to establish the extent of agreement using generalisability theory. The same 9 recoveries were also ranked by 12 experienced equine anaesthetists and the Spearman Rank Correlation coefficient calculated to determine the agreement between experienced and inexperienced evaluators.

Results: The recoveries were evaluated by 117 students. All 4 RQSSs were equally reliable with low (<4%) interobserver variability. The main (80%) source of total variation arose from differences between horses. The overall ranking within each RQSS was strongly correlated with Day 1 ranking. There was strong correlation (r = 0.983) between the students' ranking and that established by experienced anaesthetists. Interobserver reliability was similar with all 4 RQSSs.

Conclusion: All 4 RQSSs studied were similarly reliable.

Potential relevance: The selection of a universally acceptable RQSS from amongst the 4 examined can be based on criteria other than reliability, e.g. ease of use. This will facilitate wider scale multi-centre studies in recovery quality after anaesthesia in horses.

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