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      Evaluation and comparison of pain questionnaires for clinical screening of osteoarthritis in cats

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          Abstract

          Background

          Feline osteoarthritis (OA) is a common cause of long-standing pain and physical dysfunction. Performing a physical examination of a cat is often challenging. There is a need for disease-specific questionnaires or the so-called clinical metrology instruments (CMIs) to facilitate diagnosis and evaluation of treatment of feline OA. The CMI provides the owners an assessment of the cat’s behavioural and lifestyle changes in the home environment. The purpose of the study was to evaluate readability, internal consistency, reliability and discriminatory ability of four CMIs.

          Methods

          This is a prospective, cross-sectional study with 142 client-owned cats. Feline OA was diagnosed based on medical history, orthopaedic examination and radiography.

          Results

          The results indicate that all four instruments have sound readability, internal consistency, are reliable over time and have good discriminatory ability. Preliminary cut-off values with optimal sensitivity and specificity were suggested for each instrument. The osteoarthritic cats showed significant changes in behavioural response to pain during orthopaedic examination, compared with sound cats.

          Conclusion

          The results indicate that all four questionnaires make an important contribution in a clinical setting, and that the cat’s behavioural response to pain during physical examination should be a parameter to take into account as a possible indication of chronic pain.

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          Most cited references31

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          The use of receiver operating characteristic curves in biomedical informatics.

          Receiver operating characteristic (ROC) curves are frequently used in biomedical informatics research to evaluate classification and prediction models for decision support, diagnosis, and prognosis. ROC analysis investigates the accuracy of a model's ability to separate positive from negative cases (such as predicting the presence or absence of disease), and the results are independent of the prevalence of positive cases in the study population. It is especially useful in evaluating predictive models or other tests that produce output values over a continuous range, since it captures the trade-off between sensitivity and specificity over that range. There are many ways to conduct an ROC analysis. The best approach depends on the experiment; an inappropriate approach can easily lead to incorrect conclusions. In this article, we review the basic concepts of ROC analysis, illustrate their use with sample calculations, make recommendations drawn from the literature, and list readily available software.
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            Development and validation of a body condition score system for cats: a clinical tool

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              Children’s Self-Reports of Pain Intensity: Scale Selection, Limitations and Interpretation

              Most children aged five years and older can provide meaningful self-reports of pain intensity if they are provided with age-appropriate tools and training. Self-reports of pain intensity are an oversimplification of the complexity of the experience of pain, but one that is necessary to evaluate and titrate pain-relieving treatments. There are many sources of bias and error in self-reports of pain, so ratings need to be interpreted in light of information from other sources such as direct observation of behaviour, knowledge of the circumstances of the pain and parents’ reports. The pain intensity scales most commonly used with children – faces scales, numerical rating scales, visual analogue scales and others – are briefly introduced. The selection, limitations and interpretation of self-report scales are discussed.
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                Author and article information

                Journal
                Vet Rec
                Vet. Rec
                vetrec
                veterinaryrecord
                The Veterinary Record
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0042-4900
                2042-7670
                21 December 2019
                16 October 2019
                : 185
                : 24
                : 757
                Affiliations
                [1 ] departmentDepartment of Clinical Sciences , The Swedish University of Agricultural Sciences , Uppsala, Sweden
                [2 ] departmentDepartment of Clinical Sciences , North Carolina State University , Raleigh, North Carolina, USA
                Author notes
                [Correspondence to ] Dr Anna Bergh; anna.bergh@ 123456slu.se
                Author information
                https://orcid.org/0000-0002-7259-2450
                https://orcid.org/0000-0002-2950-9009
                http://orcid.org/0000-0002-5567-6249
                Article
                vetrec-2018-105115
                10.1136/vr.105115
                6996100
                31619513
                474cccb3-eb61-4415-ac6b-32c5c223b32c
                © British Veterinary Association 2019. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, an indication of whether changes were made, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 29 July 2018
                : 29 August 2019
                : 27 September 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100008015, Agria Djurförsäkring;
                Categories
                Paper
                1506
                Custom metadata
                unlocked

                Veterinary medicine
                feline,chronic pain,clinical metrology instruments,owner assessment,pressure mat technique,sensitivity

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