Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, Missouri 65211, USA.
Equine Vet J. 2010 Mar;42(2):92-7. doi: 10.2746/042516409X479568.
Previous studies have suggested that agreement between equine veterinarians subjectively evaluating lameness in horses is low. These studies were limited to small numbers of horses, evaluating movement on the treadmill or to evaluating previously-recorded videotape.
To estimate agreement between equine practitioners performing lameness evaluations in horses in the live, over ground setting.
131 mature horses were evaluated for lameness by 2-5 clinicians (mean 3.2) with a weighted-average of 18.7 years of experience. Clinicians graded each limb using the AAEP lameness scale by first watching the horse trot in a straight line only and then after full lameness evaluation. Agreement was estimated by calculation of Fleiss' (kappa). Evaluators agreed if they picked the same limb as lame or not lame regardless of the severity of perceived lameness.
After only evaluating the horse trot in a straight line clinicians agreed whether a limb was lame or not 76.6% of the time (kappa= 0.44). After full lameness evaluation clinicians agreed whether a limb was lame or not 72.9% of the time (kappa= 0.45). Agreement on forelimb lameness was slightly higher than on hindlimb lameness. When the mean AAEP lameness score was >1.5 clinicians agreed whether or not a limb was lame 93.1% of the time (kappa= 0.86), but when the mean score was < or = 1.5 they agreed 61.9% (kappa= 0.23) of the time. When given the task of picking whether or not the horse was lame and picking the worst limb after full lameness evaluation, clinicians agreed 51.6% (kappa= 0.37) of the time.
For horses with mild lameness subjective evaluation of lameness is not very reliable.
A search for and the development of more objective and reliable methods of lameness evaluation is justified and should be encouraged and supported.
既往研究提示，兽医主观评估马跛行的一致性较低。这些研究的马匹数量有限，评估在跑步机上的运动或评估先前记录的视频。
评估在实地、地面环境中进行跛行评估的马的兽医从业者之间的一致性。
131 匹成熟马由 2-5 位临床医生（平均 3.2 位）使用 AAEP 跛行量表进行跛行评估，每位临床医生的平均经验为 18.7 年。临床医生首先仅观看马直线小跑，然后进行全面跛行评估，对每条肢体进行分级。通过计算 Fleiss'（kappa）来评估一致性。评估者无论感知到的跛行严重程度如何，只要选择同一肢体跛行或非跛行，则视为一致。
仅评估马直线小跑时，临床医生判断跛行的时间有 76.6%（kappa=0.44）是一致的。全面跛行评估后，临床医生判断跛行的时间有 72.9%（kappa=0.45）是一致的。前肢跛行的一致性略高于后肢跛行。当平均 AAEP 跛行评分>1.5 时，临床医生判断跛行或非跛行的时间有 93.1%（kappa=0.86）是一致的，但平均评分<或=1.5 时，判断一致的时间为 61.9%（kappa=0.23）。在全面跛行评估后，临床医生在选择马是否跛行和选择最严重的肢体的任务中，有 51.6%（kappa=0.37）的时间是一致的。
对于轻度跛行的马，主观跛行评估的可靠性不高。
有理由寻找和开发更客观、更可靠的跛行评估方法，并应鼓励和支持。
