Agreement between veterinarians and three objective evaluation systems in naturally occurring equine lameness.
Authors: McPeek Jenna L, Menarim Bruno, Sponseller Beatrice, McClendon Margaret, Adam Emma N, Adams Amanda A, Slone Stacy, Page Allen E
Journal: Equine veterinary journal
Summary
# Editorial Summary: Objective versus Subjective Lameness Assessment in Horses Veterinary lameness evaluation relies heavily on subjective visual assessment, yet objective systems using accelerometry and artificial intelligence have emerged as potential diagnostic supplements. Researchers compared agreement between two independent veterinary evaluators and three objective systems—an AI-powered smartphone application (Sleip), the Equinosis Q Lameness Locator, and the Equisym IMU device—when assessing naturally occurring lameness in 25 horses trotted on a straight line, converting all evaluations to standardised ordinal scales for comparison. Objective systems demonstrated significantly higher inter-rater agreement (0.84) than the two veterinarians (0.73), with the Equisym system consistently achieving the highest agreement scores when compared individually against other raters; notably, forelimb assessments showed greater agreement across all evaluators (0.82) than hindlimb assessments (0.73), suggesting that detecting subtle hindlimb asymmetries remains challenging regardless of evaluation method. For practitioners, these findings indicate that objective systems may provide valuable standardisation and consistency in lameness grading, particularly useful when documenting subtle asymmetries, establishing baselines for monitoring, or when subjective assessor experience varies. Whilst straight-line evaluation has inherent limitations, the superior reproducibility of objective technology suggests incorporating these tools into routine musculoskeletal assessment protocols could strengthen diagnostic confidence and facilitate more objective communication of lameness severity across the equine healthcare team.
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Practical Takeaways
- •Consider using objective lameness evaluation systems (AI-smartphone app, IMU devices) alongside subjective veterinary examination to improve diagnostic consistency, particularly for challenging cases
- •Be aware that hindlimb lameness assessments are inherently more difficult and variable regardless of evaluation method—objective systems may help standardize these challenging evaluations
- •Objective systems can provide uniform, quantifiable data to supplement visual assessment, potentially improving diagnosis when subjective evaluation alone is inconclusive
Key Findings
- •Objective evaluation systems demonstrated higher agreement (GA2 = 0.84, 95% CI: 0.77-0.91) compared to subjective veterinary evaluation (GA2 = 0.73, 95% CI: 0.63-0.83)
- •Forelimb lameness assessment showed greater agreement across all evaluators (GA2 = 0.82) than hindlimb assessment (GA2 = 0.73)
- •Pairwise agreement between objective systems was often higher than agreement between objective systems and veterinary evaluators
- •The Equisym (ES) system frequently produced the highest agreement scores when compared individually with each rater