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对德国牧羊犬新西兰兽医协会髋关节发育不良评分系统与宾夕法尼亚大学髋关节松动指数之间一致性的评估。

An assessment of the agreement between the New Zealand Veterinary Association Hip Dysplasia Scoring System and the PennHIP Distraction Index in German Shepherd dogs.

作者信息

Worth A J, Laven R A, Erceg V H

机构信息

Centre for Service and Working Dog Health and Research, Massey University Veterinary Teaching Hospital, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.

出版信息

N Z Vet J. 2009 Dec;57(6):338-45. doi: 10.1080/00480169.2009.64720.

DOI:10.1080/00480169.2009.64720
PMID:19966893
Abstract

AIM

To determine the level of agreement between the New Zealand Veterinary Association (NZVA) Hip Dysplasia Scoring System and the University of Pennsylvania Hip Improvement Program (PennHIP) Distraction Index in German Shepherd dogs, and whether using the NZVA subtotal score or its components affected the level of agreement.

METHODS

A prospective study was performed using 47 German Shepherd police dogs undergoing breeding evaluation. All dogs were scored using the NZVA system and the PennHIP index. The relationships between the individual hip-distraction index scores and the scores from the NZVA system, i.e. the total score, the subtotal score, and the scores for the categories making up the subtotal score, were analysed using correlation, followed by univariate ANOVA for the subtotal categories alone. The scores from the NZVA system and the distraction index were then dichotomised into either low or high risk of canine hip dysplasia (CHD). A sign test was then used to determine whether three NZVA thresholds identified the same proportion of 'at-risk' dogs as the distraction-index threshold. Where this was the case, the Kappa value was calculated to identify the degree of agreement between the NZVA measures and the distraction index.

RESULTS

The left-hip distraction index was significantly correlated to both left-subtotal and left-total NZVA score, however for right-hip scores there was no such correlation. The individual categories of the subtotal NZVA score were not significantly associated with the distraction index except for the subluxation score of the left hip. The proportion of dogs identified as being 'at risk' for CHD identified using a distraction-index threshold of 0.3 was similar to that identified by an NZVA total or subtotal score of >2 (44/47 cf. 45/47, respectively). However, none of the dogs identified as low risk using the distraction index was identified as low risk by either of the NZVA scores. This poor agreement (Kappa value <0) was not improved by using a threshold of >1 in any of the categories used to calculate the NZVA score. The agreement between the two scores was improved by using different thresholds; distraction index >0.5 and an NZVA total score of >9. These thresholds identified a much lower proportion of 'at-risk' dogs (5/47 and 10/47, respectively) than the standard thresholds. The Kappa values using the thresholds of 0.5 for the distraction-index and > or = 9 for the NZVA scores were moderate for subtotal (0.55; 95% CI=0.16-0.94) and low for total (0.31; 95% CI=-0.02 to 0.63) score.

CONCLUSIONS

The low level of agreement between the NZVA total scores and the PennHIP distraction index, particularly when the standard interpretations were used, is of concern as assessing dogs by each method gave disparate results. There was evidence from this study that using the subtotal score moderately improved the level of agreement with distraction index, but only at the higher thresholds.

CLINICAL RELEVANCE

The low level of agreement between NZVA and PennHIP results in the same dog precludes them being used interchangeably to guide breeding decisions. The higher heritability of distraction-index measurement in previous studies suggests that it is a better selection tool for breeding dogs when CHD is present within a population. The advantage of a hip-extended ventrodorsal view is its low cost and widespread availability but comparisons between individuals may not be accurate due to the poor sensitivity and the presence of false negatives.

摘要

目的

确定德国牧羊犬中新西兰兽医协会(NZVA)髋关节发育不良评分系统与宾夕法尼亚大学髋关节改良计划(PennHIP)牵引指数之间的一致性水平,以及使用NZVA总分或其组成部分是否会影响一致性水平。

方法

对47只接受繁殖评估的德国牧羊犬警犬进行了一项前瞻性研究。所有犬只均使用NZVA系统和PennHIP指数进行评分。使用相关性分析个体髋关节牵引指数评分与NZVA系统评分之间的关系,即总分、总分及构成总分的各分类的分数,然后仅对总分分类进行单因素方差分析。然后将NZVA系统评分和牵引指数分为犬髋关节发育不良(CHD)低风险或高风险。然后使用符号检验来确定三个NZVA阈值所确定的“风险”犬比例是否与牵引指数阈值相同。如果是这样,则计算Kappa值以确定NZVA测量值与牵引指数之间的一致程度。

结果

左髋关节牵引指数与左总分及左NZVA总分均显著相关,但右髋关节评分则无此相关性。除左髋关节半脱位评分外,NZVA总分的各个分类与牵引指数均无显著关联。使用0.3的牵引指数阈值确定为CHD“风险”犬的比例与NZVA总分或>2的总分确定的比例相似(分别为44/47和45/47)。然而,使用牵引指数确定为低风险的犬只,NZVA评分均未将其确定为低风险。通过在用于计算NZVA评分的任何类别中使用>1的阈值,这种较差的一致性(Kappa值<0)并未得到改善。通过使用不同的阈值,两个评分之间的一致性得到了改善;牵引指数>0.5且NZVA总分>9。这些阈值所确定的“风险”犬比例(分别为5/47和10/47)远低于标准阈值。使用牵引指数阈值0.5和NZVA评分≥9时,总分的Kappa值中等(0.55;95%CI=0.16-0.94),总分的Kappa值较低(0.31;95%CI=-0.02至0.63)。

结论

NZVA总分与PennHIP牵引指数之间的一致性水平较低,尤其是在使用标准解释时,令人担忧,因为每种方法对犬只的评估结果不同。本研究有证据表明,使用总分适度提高了与牵引指数的一致性水平,但仅在较高阈值时。

临床相关性

NZVA和PennHIP之间一致性水平较低,导致同一只犬的结果不同,这使得它们不能互换使用以指导繁殖决策。先前研究中牵引指数测量的遗传力较高,表明当群体中存在CHD时,它是更好的种犬选择工具。髋关节伸展腹背位的优点是成本低且广泛可用,但由于敏感性差和存在假阴性,个体之间的比较可能不准确。

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