Abstract
This study aimed to evaluate the agreement and reliability of the Feline Grimace Scale (FGS) among cat owners, veterinarians, veterinary students and nurses/technicians. Raters (n = 5/group) scored 100 images using the FGS (ear position, orbital tightening, muzzle tension, whiskers position and head position). Intra-class correlation coefficients (ICC) were used to assess inter- and intra-rater reliability. Agreement between each group and the veterinarian group (gold-standard) was calculated using the Bland–Altman method. Effects of gender, age and number of cats owned on FGS scores were assessed using linear mixed models. Inter-rater reliability was good for FGS final scores (ICC > 0.8). The muzzle and whiskers yielded lower reliability (ICC = 0.39 to 0.74). Intra-rater reliability was excellent for students and veterinarians (ICC = 0.91), and good for owners and nurses (ICC = 0.87 and 0.81, respectively). A very good agreement between all groups and veterinarians (bias < 0.1 and narrow limits of agreement) was observed. Female raters assigned higher FGS scores than males (p = 0.006); however, male raters were underrepresented in this study. Scores were not affected by age or number of cats owned. The FGS is reliable for feline acute pain assessment when used by individuals with different experience.
Highlights
This study aimed to evaluate the agreement and reliability of the Feline Grimace Scale (FGS) among cat owners, veterinarians, veterinary students and nurses/technicians
This study assessed the reliability and agreement of the FGS scores among four groups with different levels of expertise in feline pain assessment. It demonstrated the effect of gender, age and the number of cats owned by raters on the FGS scores
This study demonstrated good reliability for the action units (AU) ears and eyes for all groups (ICC single > 0.75), and moderate to good for the AU head position [Intra-class correlation coefficients (ICC) single = 0.66 and 0.74 -moderate for owners and students, respectively, and ICC single = 0.8 and 0.78—good for nurses and veterinarians, respectively)
Summary
This study aimed to evaluate the agreement and reliability of the Feline Grimace Scale (FGS) among cat owners, veterinarians, veterinary students and nurses/technicians. A facial expression-based tool has been published for acute pain assessment in cats namely the Feline Grimace Scale (FGS)[12]. It comprises five AU: ear position, orbital tightening, muzzle tension, whiskers position and head position. This instrument has reported validity and reliability in different painful conditions for use by v eterinarians[12,13] using both image and real-time assessment[14]. The objectives of this study were to assess the agreement and Scientific Reports | (2021) 11:5262
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