Inter-observer agreement of canine and feline paroxysmal event semiology and classification by veterinary neurology specialists and non-specialists

BMC Veterinary Research

Holger A Volk⁸  Andrea Tipold⁴  Fran Taylor-Brown⁸  Veronika M Stein⁴  Clare Rusbridge⁷  Stephanie M Preston⁸  Akos Pakozdy⁵  Paul JJ Mandigers⁶  Myfanwy Hill⁸  Rachel Hampel⁸  Robyn Farquhar^1,11  Luisa De Risio¹  Sigitas Cizinauskas⁹  Marios Charalambous²  Sofie Bhatti³  Mette Berendt^1,10  Rowena MA Packer⁸ 

[1] Animal Health Trust, Lanwades Park, Newmarket, UK;Cornell University College of Veterinary Medicine, Ithaca, New York, USA;Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium;Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Buenteweg 9, Hannover, 30559, Germany;University Clinic for Small Animals, Clinical Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria;Department of Clinical Sciences of Companion Animals, Utrecht University, Utrecht, The Netherlands;School of Veterinary Medicine, Faculty of Health & Medical Sciences, University of Surrey, Surrey, UK;Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, UK;The Referral Animal Neurology Hospital “Aisti”, Vantaa, Finland;Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark;Fernside Veterinary Centre, Hertfordshire, UK

关键词: Kappa;    Agreement;    Paroxysmal event;    Video;    Feline;    Canine;    Epilepsy;    Seizure;   

Others  :  1131388
DOI  :  10.1186/s12917-015-0356-2

 received in 2014-10-23, accepted in 2015-02-06,  发布年份 2015

【 摘 要 】

Background

Advances in mobile technology mean vets are now commonly presented with videos of paroxysmal events by clients, but the consistency of the interpretation of these videos has not been investigated. The objective of this study was to investigate the level of agreement between vets (both neurology specialists and non-specialists) on the description and classification of videos depicting paroxysmal events, without knowing any results of diagnostic workup. An online questionnaire study was conducted, where participants watched 100 videos of dogs and cats exhibiting paroxysmal events and answered questions regarding: epileptic seizure presence (yes/no), seizure type, consciousness status, and the presence of motor, autonomic and neurobehavioural signs. Agreement statistics (percentage agreement and kappa) calculated for each variable, with prevalence indices calculated to aid their interpretation.

Results

Only a fair level of agreement (κ = 0.40) was found for epileptic seizure presence. Overall agreement of seizure type was moderate (κ = 0.44), with primary generalised seizures showing the highest level of agreement (κ = 0.60), and focal the lowest (κ =0.31). Fair agreement was found for consciousness status and the presence of autonomic signs (κ = 0.21–0.40), but poor agreement for neurobehavioral signs (κ = 0.16). Agreement for motor signs ranged from poor (κ = ≤ 0.20) to moderate (κ = 0.41–0.60). Differences between specialists and non-specialists were identified.

Conclusions

The relatively low levels of agreement described here highlight the need for further discussions between neurology experts regarding classifying and describing epileptic seizures, and additional training of non-specialists to facilitate accurate diagnosis. There is a need for diagnostic tools (e.g. electroencephalogram) able to differentiate between epileptic and non-epileptic paroxysms.

【 授权许可】

   
2015 Packer et al.; licensee BioMed Central.

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