Prospective Feasibility and Revalidation of the Equine Acute Abdominal Pain Scale (EAAPS) in Clinical Cases of Colic in Horses.

Yamit Maskato,Ellen Singer,Gila Sutton,Gal Kelmer,Alexandra Dugdale

doi:10.3390/ani10122242

Yamit Maskato, Ellen Singer + Show 3 more

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https://doi.org/10.3390/ani10122242

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Abstract

Simple SummarySeverity of pain, an important parameter in clinical decision making, is subjective. The Equine Acute Abdominal Pain Scale (EAAPS) was evaluated for the first time in 237 horses presenting with colic (abdominal pain) at two equine hospitals; in Israel and in the United Kingdom. The EAAPS demonstrated validity and was reportedly quick and easy to use. The EAAPS is the only equine pain scale that has been tested to this extent for these properties on clinical cases in equine hospitals. Use of the EAAPS apparently requires no training, is easy to use in clinical cases, and can improve equine welfare.Assessment of the severity of pain in colic cases is subjective. The Equine Acute Abdominal Pain Scale (EAAPS), previously validated using film clips of horses with colic, was tested for feasibility and revalidated in both medical and surgical colic cases in Israel and the UK. Feasibility qualities evaluated were quickness and ease-of-use. Pain in 231 horses, presented for colic, was assessed by 35 participants; 26 in the UK and 9 in Israel. Without prior training, participants assessed the severity of pain using two scales; the EAAPS and a visual analogue scale (VAS). Convergent validity comparing the EAAPS to the VAS was substantial, discriminant validity was good, and predictive validity for surgical treatment was similar to the VAS, but for mortality, the VAS was significantly better. No participants reported the EAAPS to be “very slow” or “very difficult” to use. The mode reported was “quick”/“very quick” and “easy”/“very easy” to use, though in less than 10% of cases, it was reported to be a little less quick or easy. More experienced first-time users found it significantly quicker to use than less experienced participants. In conclusion, the EAAPS is the only equine pain assessment scale that has been tested and found to demonstrate good feasibility for use in the referral hospital setting.

Highlights

Colic is a common condition of horses characterised by abdominal pain and high mortality
The Equine Acute Abdominal Pain Scale (EAAPS) has been shown to have significantly higher interobserver and intraobserver reliabilities than either global scale, visual analogue scales (VAS) or numerical rating scales (NRS) or another simple descriptive scale [8,15,16,17]. These results indicate that EAAPS can be relied upon due to its reproducibility [10,13,14]
The aim of this study was to evaluate the use of the EAAPS by hospital staff in real time

Summary

Introduction

Colic is a common condition of horses characterised by abdominal pain and high mortality. In 2015, it caused 31% of deaths in horses aged 1 to 20 years, making it the most common cause of equine death. Pain assessment is subjective [4]; when global rating scales, such as numerical rating scales (NRS) and visual analogue scales (VAS), are used, experience with horses [5] and interpretation of pain depends on understanding the species’ normal behaviour. A major difficulty with global rating scales, lacking any descriptive criteria for pain assessment, is that they may be subject to many observer biases [6]. They are not very reliable [7,8], and in repeated measurements, measurement error causes inconsistent results [9]

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