Holton L L, Scott E M, Nolan A M, Reid J, Welsh E, Flaherty D
Department of Veterinary Pharmacology, University of Glasgow Veterinary School, Scotland.
J Am Vet Med Assoc. 1998 Jan 1;212(1):61-6.
To investigate the reliability of 3 scales used for assessment of pain in dogs.
Prospective study.
50 dogs that had surgery.
Dogs were allocated into 3 groups (group 1, 25 dogs assessed 1 hour after the end of surgery; group 2, 41 dogs assessed between 21 and 27 hours after the end of surgery; group 3, 16 dogs assessed on the day of surgery and on the subsequent day). Each dog was scored for pain 4 times by 3 (groups 1 and 3) or 4 (group 2) veterinarians, using all 3 scales (i.e. simple descriptive, numerical rating, and visual analogue) during each scoring period. Analysis of data was performed using ANOVA, log-linear modeling, calculation of reproducibility coefficients, and Cohen's kappa statistic.
Significant variability existed among observers for use of all 3 scales. Variability among observers and between observers and dogs accounted for 29 to 36% of the total variability (group 1, 36.1 and 32.3% and group 2, 35.1 and 29.7%, for visual analogue scale and numerical rating scale scores, respectively). Kappa statistic values calculated for data obtained by use of the simple descriptive scale indicated that agreement was fair for the observers (group 1, 0.244 to 0.299; group 2, 0.211 to 0.368; group 3, 0.233 to 0.321).
Analysis of pain score data in dogs must incorporate observer variability when more than 1 observer is used. Comparative analysis of data accrued from pain studies in various hospitals must account for this variability.
研究用于评估犬疼痛的3种量表的可靠性。
前瞻性研究。
50只接受手术的犬。
将犬分为3组(第1组,25只犬在手术结束后1小时进行评估;第2组,41只犬在手术结束后21至27小时进行评估;第3组,16只犬在手术当天及随后一天进行评估)。在每个评分阶段,由3名(第1组和第3组)或4名(第2组)兽医使用所有3种量表(即简单描述性量表、数字评分量表和视觉模拟量表)对每只犬进行4次疼痛评分。使用方差分析、对数线性模型、再现性系数计算和科恩kappa统计量进行数据分析。
所有3种量表在观察者之间均存在显著差异。观察者之间以及观察者与犬之间的差异占总差异的29%至36%(对于视觉模拟量表和数字评分量表得分,第1组分别为36.1%和32.3%,第2组分别为35.1%和29.7%)。使用简单描述性量表获得的数据计算出的kappa统计量值表明观察者之间的一致性为中等(第1组,0.244至0.299;第2组,0.211至0.368;第3组,0.233至0.321)。
当使用多名观察者时,犬疼痛评分数据的分析必须考虑观察者的差异。不同医院疼痛研究积累的数据的比较分析必须考虑这种差异。