McGivney C L, Sweeney J, Gough K F, Hill E W, Katz L M
UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland.
UCD School of Business, University College Dublin, Belfield, Dublin, Ireland.
Equine Vet J. 2019 Mar;51(2):192-197. doi: 10.1111/evj.12994. Epub 2018 Aug 25.
We hypothesised that grade/appearance for upper respiratory tract (URT) disorders identified at the first overground endoscopy (OGE) examination would vary at subsequent examinations.
To compare OGE examinations from horses evaluated on at least two occasions under similar exercise conditions without treatment intervention.
Retrospective cohort.
Pre-exercise and exercising OGE recordings from Thoroughbred horses undergoing multiple examinations under similar exercise conditions were reviewed, with the first two recordings for each horse statistically evaluated. Paired Wilcoxon signed-rank tests were used to assess differences in exercise and physiological parameters between examinations. Z-tests were used to assess the proportion of changes in URT disorder grade/appearance between examinations. A McNemar's test was used to compare the proportion of horses with each disorder at each examination. Test-retest reliability across examinations was assessed using Spearman's ρ, and ordered logistic regression used to explore temporal effects on repeatability. Lattice plots were constructed to view variability in disorders over time.
Seventy-eight horses (median age 2.4 years) with 195 resting endoscopic examinations including 72/78 horses with 179 pre-exercise and exercising OGE examinations were evaluated. Median time between examinations was 226.5 days with no differences between exercise and physiological parameters. Grades significantly varied between examinations for all disorders, and in particular for palatal instability (PI) and epiglottic grade at rest. A temporal link between examination interval and disorder grade change was identified for PI and resting arytenoid asymmetry.
OGE re-examinations within a shorter, more consistent time-frame would allow determination of intrahorse variability. The sample size was inadequate to conclusively establish temporal links between disorders and time between examinations.
Variability for most URT abnormalities identified with OGE should be considered when making therapeutic decisions based on a single examination and may partially explain development of additional URT conditions after surgical intervention. The Summary is available in Portuguese - see Supporting Information.
我们假设在首次地面内窥镜检查（OGE）中发现的上呼吸道（URT）疾病的分级/外观在后续检查中会有所不同。
比较在相似运动条件下未经治疗干预至少接受过两次评估的马匹的OGE检查结果。
回顾性队列研究。
对在相似运动条件下接受多次检查的纯种马的运动前和运动时的OGE记录进行回顾，并对每匹马的前两次记录进行统计学评估。使用配对Wilcoxon符号秩检验来评估两次检查之间运动和生理参数的差异。Z检验用于评估两次检查之间URT疾病分级/外观变化的比例。McNemar检验用于比较每次检查时患有每种疾病的马匹比例。使用Spearman's ρ评估多次检查之间的重测可靠性，并使用有序逻辑回归来探索时间对可重复性的影响。构建点阵图以观察疾病随时间的变异性。
对78匹马（中位年龄2.4岁）进行了评估，包括195次静息内窥镜检查，其中72/78匹马进行了179次运动前和运动时的OGE检查。两次检查之间的中位时间为226.5天，运动和生理参数之间无差异。所有疾病在两次检查之间的分级有显著差异，尤其是静止时的腭不稳定（PI）和会厌分级。对于PI和静止时的杓状软骨不对称，确定了检查间隔与疾病分级变化之间的时间联系。
在更短、更一致的时间框架内进行OGE复查将有助于确定马匹内部的变异性。样本量不足以最终确定疾病与检查间隔时间之间的时间联系。
在基于单次检查做出治疗决策时，应考虑OGE发现的大多数URT异常的变异性，这可能部分解释手术干预后额外URT疾病的发生。总结内容有葡萄牙语版本 - 见支持信息。
