Development, Validation, and Reliability of a Sedation Scale in Horses (EquiSed).
Authors: de Oliveira Alice Rodrigues, Gozalo-Marcilla Miguel, Ringer Simone Katja, Schauvliege Stijn, Fonseca Mariana Werneck, Trindade Pedro Henrique Esteves, Puoli Filho José Nicolau Prospero, Luna Stelio Pacca Loureiro
Journal: Frontiers in veterinary science
Summary
# EquiSed: A New Standardised Sedation Scale for Horses Sedation assessment in equine practice has long suffered from a lack of standardisation, making it difficult to compare clinical outcomes across studies and practitioners. Rodrigues and colleagues developed and validated the EquiSed scale by administering various sedative protocols (detomidine alone or combined with methadone, and acepromazine) to seven horses whilst recording their responses at baseline, peak sedation, intermediate and end points; four independent evaluators then blindly assessed randomised video footage in two phases separated by one month. The scale demonstrated strong intra-observer reliability (0.84–0.94) and moderate-to-good inter-observer reliability (0.45–0.88), with excellent criterion validity confirmed by high correlations with existing assessment methods (0.70–0.77) and objective measures such as head height above ground (−0.52); notably, EquiSed achieved 96% sensitivity and 83% specificity for detecting meaningful sedation at a cut-off score of 7. For farriers, vets and physiotherapists managing sedated horses, this validated tool offers a reproducible, objective framework for quantifying sedation depth, improving communication between handlers, enabling more consistent clinical decision-making about procedure timing, and facilitating meaningful comparison of sedative efficacy across different drug protocols and patient populations.
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Practical Takeaways
- •EquiSed provides a standardized, reliable method for objectively assessing sedation depth in clinical and research settings, improving consistency and reproducibility across practitioners
- •The scale demonstrates excellent sensitivity (96%) for detecting adequate sedation, making it useful for monitoring sedation adequacy during procedures
- •With good validity metrics, EquiSed can replace subjective assessment methods and facilitate better communication about sedation levels between clinicians
Key Findings
- •EquiSed sedation scale demonstrated good intra-observer reliability (ICC 0.84-0.94) and acceptable inter-observer reliability (ICC 0.45-0.88)
- •Criterion validity confirmed with strong correlation between EquiSed and visual analog (0.77), numerical rating (0.76), and simple descriptive scales (0.70)
- •EquiSed showed 96% sensitivity and 83% specificity at cut-off score of 7 for detecting sedation
- •Internal consistency was good (Cronbach's α = 0.73) with all scale items having principal component factor loadings ≥0.50