Marco-Martorell Mireia, Duffy Natalie, Martinez Miguel, Maddox Thomas, Robson Katherine
Leahurst Campus, University of Liverpool, Chester High Road, Neston CH64 7TE, UK.
Northwest Veterinary Specialists, Linnaeus Veterinary Limited, Ashville Point, Beechwood, Sutton Weaver, Runcorn WA7 3FW, UK.
Animals (Basel). 2024 Aug 8;14(16):2310. doi: 10.3390/ani14162310.
Several pain scoring systems have been validated to measure pain in dogs. However, pain may not be adequately assessed since these tools are associated with high-level inter-observer variation. The aim of this study is to evaluate the agreement of pain assessment using the CMPS-SF between veterinary students, veterinary nurses, veterinary surgeons, and European College of Veterinary Anaesthesia and Analgesia (ECVAA) diplomates. Forty-five client-owned dogs presented to a teaching hospital were enrolled in this prospective, observational study. All dogs were pain-scored in vivo, while a video of the assessment was recorded and subsequently evaluated by twenty assessors, with five per group. Mean scores between groups were compared, and agreement within groups and agreement of the average scores between groups were assessed by calculating the intraclass correlation coefficient (ICC). The intervention point at which dogs were deemed to require additional analgesia was also evaluated. Overall agreement of pain assessment was poor (ICC = 0.494). Nurses had the best inter-observer agreement (ICC = 0.656), followed by ECVAA diplomates (ICC = 0.540), veterinary surgeons (ICC = 0.478), and veterinary students (ICC = 0.432). The best inter-group agreement was between veterinary surgeons and nurses (ICC = 0.951) and between ECVAA diplomates and nurses (ICC = 0.951). Students were more likely to determine that additional analgesia was required compared to other groups. Pain assessment is key for animal welfare, and training in this area should be reinforced to improve consistency.
已有多种疼痛评分系统经过验证可用于测量犬类的疼痛。然而，由于这些工具存在高水平的观察者间差异，疼痛可能无法得到充分评估。本研究的目的是评估兽医学生、兽医护士、兽医外科医生以及欧洲兽医麻醉与镇痛学院（ECVAA）的专科医生使用CMPS-SF进行疼痛评估的一致性。本前瞻性观察研究纳入了45只送至教学医院的客户拥有的犬只。所有犬只均在活体状态下进行疼痛评分，同时记录评估视频，随后由20名评估者进行评估，每组5人。比较各组之间的平均评分，并通过计算组内相关系数（ICC）评估组内一致性以及各组平均评分之间的一致性。还评估了判定犬只需要额外镇痛的干预点。疼痛评估的总体一致性较差（ICC = 0.494）。护士的观察者间一致性最佳（ICC = 0.656），其次是ECVAA专科医生（ICC = 0.540）、兽医外科医生（ICC = 0.478）和兽医学生（ICC = 0.432）。组间一致性最佳的是兽医外科医生与护士之间（ICC = 0.951）以及ECVAA专科医生与护士之间（ICC = 0.951）。与其他组相比，学生更有可能判定需要额外镇痛。疼痛评估对动物福利至关重要，应加强该领域的培训以提高一致性。
