Prevalence of adverse events and their effect on completion of high speed treadmill exercise tests at a single institution (2000-2015).
Authors: Brown K, Stefanovski D, Davidson E
Journal: Equine veterinary journal
Summary
# Editorial Summary: Adverse Events During High-Speed Treadmill Exercise Testing Over a 15-year period, Brown and colleagues reviewed 1,003 horses presented for high-speed treadmill (HSTM) evaluation at a single institution, with 900 ultimately undergoing exercise tests; using logistic regression analysis, they documented adverse events in 15% of completed tests and determined how these incidents affected test completion rates and diagnostic yield. Whilst adverse events significantly reduced the likelihood of test completion, the relationship was variable depending on event type—notably, 71% of horses experiencing adverse events still completed their tests, and 66% of the 193 incomplete tests yielded a diagnosis of the underlying poor performance cause despite early termination. The findings provide reassurance that HSTM testing remains a valuable diagnostic tool for equine practitioners investigating performance problems, with adverse events occurring sufficiently infrequently that they should not deter use of the protocol; however, the variable impact of different event types warrants careful consideration of which complications truly compromise diagnostic utility versus those that merely appear alarming without affecting test completion or diagnostic outcome. The study's retrospective design and reliance on multiple observers across 15 years represent limitations, and the authors acknowledge that analysing individual tests rather than individual horses cannot account for repeated testing in the same animal.
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Practical Takeaways
- •HSTM exercise testing remains a viable diagnostic tool for poor performance cases, with adverse events occurring in only 15% of tests and most not preventing completion
- •Even when tests cannot be completed, most cases yield a diagnostic finding regarding the performance problem, so the test should not be abandoned prematurely
- •Clinicians should recognize that different types of adverse events have variable impacts on test completion and diagnostic yield
Key Findings
- •90% of horses presenting for HSTM evaluation underwent testing, with 807 (90%) completing the exercise test
- •Adverse events occurred in 136 (15%) HSTM exercise tests, but only 39 (29%) resulted in incomplete testing
- •Adverse events significantly reduced likelihood of test completion, though effects varied by event type
- •66% of incomplete tests were terminated due to poor performance abnormalities in which diagnosis was still achieved