Comparison of three methods used for assessment of pain in dogs

Lynne Louise Holton From the Departments of Veterinary Pharmacology (Holton, Nolan, Welsh) and Clinical Studies (Reid, Flaherty), University of Glasgow Veterinary School, Bearsden Rd, Glasgow, Scotland G61 1QH, and Department of Statistics, University of Glasgow, Glasgow, Scotland G12 8QQ (Scott).

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Ethel Marian Scott From the Departments of Veterinary Pharmacology (Holton, Nolan, Welsh) and Clinical Studies (Reid, Flaherty), University of Glasgow Veterinary School, Bearsden Rd, Glasgow, Scotland G61 1QH, and Department of Statistics, University of Glasgow, Glasgow, Scotland G12 8QQ (Scott).

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Andrea Mary Nolan From the Departments of Veterinary Pharmacology (Holton, Nolan, Welsh) and Clinical Studies (Reid, Flaherty), University of Glasgow Veterinary School, Bearsden Rd, Glasgow, Scotland G61 1QH, and Department of Statistics, University of Glasgow, Glasgow, Scotland G12 8QQ (Scott).

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Jacqueline Reid From the Departments of Veterinary Pharmacology (Holton, Nolan, Welsh) and Clinical Studies (Reid, Flaherty), University of Glasgow Veterinary School, Bearsden Rd, Glasgow, Scotland G61 1QH, and Department of Statistics, University of Glasgow, Glasgow, Scotland G12 8QQ (Scott).

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Elizabeth Welsh From the Departments of Veterinary Pharmacology (Holton, Nolan, Welsh) and Clinical Studies (Reid, Flaherty), University of Glasgow Veterinary School, Bearsden Rd, Glasgow, Scotland G61 1QH, and Department of Statistics, University of Glasgow, Glasgow, Scotland G12 8QQ (Scott).

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Derek Flaherty From the Departments of Veterinary Pharmacology (Holton, Nolan, Welsh) and Clinical Studies (Reid, Flaherty), University of Glasgow Veterinary School, Bearsden Rd, Glasgow, Scotland G61 1QH, and Department of Statistics, University of Glasgow, Glasgow, Scotland G12 8QQ (Scott).

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Objective

To investigate the reliability of 3 scales used for assessment of pain in dogs.

Design

Prospective study.

Animals

50 dogs that had surgery.

Procedure

Dogs were allocated into 3 groups (group 1, 25 dogs assessed 1 hour after the end of surgery; group 2, 41 dogs assessed between 21 and 27 hours after the end of surgery; group 3, 16 dogs assessed on the day of surgery and on the subsequent day). Each dog was scored for pain 4 times by 3 (groups 1 and 3) or 4 (group 2) veterinarians, using all 3 scales (ie, simple descriptive, numerical rating, and visual analogue) during each scoring period. Analysis of data was performed using ANOVA, loglinear modeling, calculation of reproducibility coefficients, and Cohen's kappa statistic.

Results

Significant variability existed among observers for use of all 3 scales. Variability among observers and between observers and dogs accounted for 29 to 36% of the total variability (group 1, 36.1 and 32.3% and group 2, 35.1 and 29.7%, for visual analogue scale and numerical rating scale scores, respectively). Kappa statistic values calculated for data obtained by use of the simple descriptive scale indicated that agreement was fair for the observers (group 1, 0.244 to 0.299; group 2, 0.211 to 0.368; group 3, 0.233 to 0.321).

Clinical Implications

Analysis of pain score data in dogs must incorporate observer variability when more than 1 observer is used. Comparative analysis of data accrued from pain studies in various hospitals must account for this variability. (J Am Vet Med Assoc 1998;212:61–66)

Objective

To investigate the reliability of 3 scales used for assessment of pain in dogs.

Design

Prospective study.

Animals

50 dogs that had surgery.

Procedure

Dogs were allocated into 3 groups (group 1, 25 dogs assessed 1 hour after the end of surgery; group 2, 41 dogs assessed between 21 and 27 hours after the end of surgery; group 3, 16 dogs assessed on the day of surgery and on the subsequent day). Each dog was scored for pain 4 times by 3 (groups 1 and 3) or 4 (group 2) veterinarians, using all 3 scales (ie, simple descriptive, numerical rating, and visual analogue) during each scoring period. Analysis of data was performed using ANOVA, loglinear modeling, calculation of reproducibility coefficients, and Cohen's kappa statistic.

Results

Significant variability existed among observers for use of all 3 scales. Variability among observers and between observers and dogs accounted for 29 to 36% of the total variability (group 1, 36.1 and 32.3% and group 2, 35.1 and 29.7%, for visual analogue scale and numerical rating scale scores, respectively). Kappa statistic values calculated for data obtained by use of the simple descriptive scale indicated that agreement was fair for the observers (group 1, 0.244 to 0.299; group 2, 0.211 to 0.368; group 3, 0.233 to 0.321).

Clinical Implications

Analysis of pain score data in dogs must incorporate observer variability when more than 1 observer is used. Comparative analysis of data accrued from pain studies in various hospitals must account for this variability. (J Am Vet Med Assoc 1998;212:61–66)

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