Taffin Elien R L, Paepe Dominique, Campos Miguel, Duchateau Luc, Goris Nesya, De Roover Katrien, Daminet Sylvie
1 Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
2 Department of Comparative Physiology and Biometrics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
J Feline Med Surg. 2016 Nov;18(11):913-920. doi: 10.1177/1098612X15610620. Epub 2016 Jul 9.
Objectives The Karnofsky score (KS) modified for cats, a scoring system to rate health and quality of life (QOL) in cats, is used in clinical trials, but its reliability and validity are yet to be determined. The present study aims to evaluate the scientific robustness of the KS when adapted for use in a hospital setting. Methods A list of variables to consider during the physical examination, which informs the clinician's score (CS) part of the KS, was added and clinicians were allowed to choose a score anywhere between 0 and 50. The Karnofsky QOL questionnaire was adapted for use in a hospital setting. F-tests with Bonferroni correction and Spearman rank correlation coefficients were used to evaluate reliability and validity of the KS to assess the health and wellbeing of cats in a hospital setting. The records of 54 feline immunodeficiency virus-positive cats, which were recruited for a clinical trial and hospitalised for 6 weeks, were reviewed. Four veterinarians scored the CS, and one veterinarian and a veterinary nurse assessed the QOL score. Results Mean absolute difference between observers was significantly larger for the CS than for the QOL score ( P <0.001) and two veterinarians scored significantly higher than the remaining two veterinarians ( P <0.001). Inter-observer correlation ranged from 0.45-0.75 for the CS. For the QOL score, the absolute difference between observers was small, no significant difference was found between observers and a high degree of inter-observer correlation was noted (r = 0.91). Conclusions and relevance The results indicate low inter-observer reliability for the CS, requiring additional modifications to this part of the KS. The QOL score seems more reliable, and the questionnaire may serve as a reliable tool in the assessment of QOL in cats in a hospital setting. Consequently, further adaptation of the KS is mandatory when simultaneous assessment of both the cat's clinical health and perceived wellbeing is required.
目的 用于评估猫健康和生活质量（QOL）的改良卡诺夫斯基评分（KS）在猫科动物中使用的评分系统，在临床试验中被采用，但其可靠性和有效性尚未确定。本研究旨在评估在医院环境中使用时KS的科学稳健性。方法 在体格检查过程中添加了一系列供临床医生参考的变量清单，这构成了KS中临床医生评分（CS）部分，临床医生可在0至50分之间选择一个分数。卡诺夫斯基生活质量问卷被改编用于医院环境。采用经Bonferroni校正的F检验和Spearman等级相关系数来评估KS在评估医院环境中猫的健康和幸福状况时的可靠性和有效性。回顾了54只猫免疫缺陷病毒阳性猫的记录，这些猫被招募参加一项临床试验并住院6周。四位兽医对CS进行评分，一位兽医和一名兽医护士评估生活质量评分。结果 观察者之间CS的平均绝对差异显著大于生活质量评分（P<0.001），并且两位兽医的评分显著高于另外两位兽医（P<0.001）。CS的观察者间相关性在0.45 - 0.75之间。对于生活质量评分，观察者之间的绝对差异较小，观察者之间未发现显著差异，并且观察者间相关性较高（r = 0.91）。结论及相关性 结果表明CS的观察者间可靠性较低，需要对KS的这一部分进行进一步修改。生活质量评分似乎更可靠，并且该问卷可作为评估医院环境中猫生活质量的可靠工具。因此，当需要同时评估猫的临床健康状况和感知幸福感时，对KS进行进一步调整是必要的。
