Reliability of three scoring systems for assessing quality of anaesthetic induction in horses.
Authors: Villalba-Díez Marta, Benavente-Sánchez Leire, Bustamante Rocío, Santiago-Llorente Isabel, Villalba-Orero María
Journal: Equine veterinary journal
Summary
# Editorial Summary Assessing the quality of anaesthetic induction in horses is clinically important but has lacked standardised methodology; this study evaluated the reliability of three scoring systems—the visual analogue scale (VAS), simple descriptive scale (SDS), and a novel composite grading scale (CGS)—by having four experienced equine anaesthetists independently score eight video-recorded inductions twice over a one-month interval. Inter-rater reliability was moderate to good across all three systems, with the VAS performing strongest (ICC 0.74), whilst intra-rater reliability was considerably higher, ranging from very good for VAS and SDS (ICC 0.82 and 0.81 respectively) to excellent for the CGS (ICC 0.91). For research applications requiring multiple independent assessors, the VAS offers the most consistent inter-observer agreement and is recommended for routine inclusion in induction quality evaluation; conversely, the novel CGS demonstrates superior internal consistency when a single observer is conducting assessments. These findings validate all three systems as reliable tools but highlight that choice of scale should be pragmatically matched to study design, with the caveat that assessments were based on video recordings without audio, which may not fully capture clinical induction quality in real-time practice settings.
Read the full abstract on PubMed
Practical Takeaways
- •If your practice uses multiple clinicians assessing induction quality for research or quality assurance, adopt the visual analogue scale for consistency across evaluators
- •The novel composite grading scale offers the most reliable single-observer assessment tool if one veterinarian routinely evaluates your anaesthetic protocols
- •Standardized scoring systems for induction quality can improve communication about anaesthetic outcomes and help identify which induction drugs or protocols work best in your facility
Key Findings
- •Visual analogue scale (VAS) demonstrated the highest inter-rater reliability (ICC 0.74±0.11) among three scoring systems evaluated
- •Composite grading scale (CGS) showed excellent intra-rater reliability (0.91±0.08), superior to VAS and simple descriptive scale (SDS)
- •All three scoring systems demonstrated moderate to good inter-rater agreement, with intra-rater agreement ranging from very good to excellent
- •VAS is recommended for multi-evaluator research studies while CGS is preferred for single-observer assessments of anaesthetic induction quality