{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:52:56Z","timestamp":1793123576278,"version":"4.5.0"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:00:00Z","timestamp":1628121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2017\/12815-0"],"award-info":[{"award-number":["2017\/12815-0"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["168965"],"award-info":[{"award-number":["168965"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010298","name":"Dorothy Russell Havemeyer Foundation","doi-asserted-by":"publisher","award":["2016 5-27134"],"award-info":[{"award-number":["2016 5-27134"]}],"id":[{"id":"10.13039\/100010298","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Narkovet LLC","award":["SR-NVC-USA 02-2018"],"award-info":[{"award-number":["SR-NVC-USA 02-2018"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Proper pain therapy requires adequate pain assessment. This study evaluated the reliability and validity of the Unesp-Botucatu horse acute pain scale (UHAPS), the Orthopedic Composite Pain Scale (CPS) and unidimensional scales in horses admitted for orthopedic and soft tissue surgery. Forty-two horses were assessed and videotaped before surgery, up to 4 hours postoperatively, up to 3 hours after analgesic treatment, and 24 hours postoperatively (168 video clips). After six evaluators viewing each edited video clip twice in random order at a 20-day interval, they chose whether analgesia would be indicated and applied the Simple Descriptive, Numeric and Visual Analog scales, CPS, and UHAPS. For all evaluators, intra-observer reliability of UHAPS and CPS ranged from 0.70 to 0.97. Reproducibility was variable among the evaluators and ranged from poor to very good for all scales. Principal component analysis showed a weak association among 50% and 62% of the UHAPS and CPS items, respectively. Criterion validity based on Spearman correlation among all scales was above 0.67. Internal consistency was minimally acceptable (0.51\u20130.64). Item-total correlation was acceptable (0.3\u20130.7) for 50% and 38% of UHAPS and CPS items, respectively. UHAPS and CPS were specific (90% and 79% respectively), but both were not sensitive (43 and 38%, respectively). Construct validity (responsiveness) was confirmed for all scales because pain scores increased after surgery. The cut-off point for rescue analgesia was \u2265 5 and \u2265 7 for the UHAPS and CPS, respectively. All scales presented adequate repeatability, criterion validity, and partial responsiveness. Both composite scales showed poor association among items, minimally acceptable internal consistency, and weak sensitivity, indicating that they are suboptimal instruments for assessing postoperative pain. Both composite scales require further refinement with the exclusion of redundant or needless items and reduction of their maximum score applied to each item or should be replaced by other tools.<\/jats:p>","DOI":"10.1371\/journal.pone.0255618","type":"journal-article","created":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T17:32:35Z","timestamp":1628184755000},"page":"e0255618","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":21,"title":["A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses"],"prefix":"10.1371","volume":"16","author":[{"given":"Paula","family":"Barreto da Rocha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Driessen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue M.","family":"McDonnell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Hopster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Zarucco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Gozalo-Marcilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Hopster-Iversen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Henrique","family":"Esteves Trindade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thamiris Kristine","family":"Gonzaga da Rocha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilda Onghero","family":"Taffarel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna Bodini","family":"Alonso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stijn","family":"Schauvliege","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5312-9076","authenticated-orcid":true,"given":"Stelio Pacca Loureiro","family":"Luna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,8,5]]},"reference":[{"key":"pone.0255618.ref001","doi-asserted-by":"crossref","first-page":"266","DOI":"10.2527\/1997.751266x","article-title":"Assessment of acute pain in farm animals using behavioral and physiological measurements","volume":"75","author":"V Molony","year":"1997","journal-title":"J Anim Sci"},{"key":"pone.0255618.ref002","article-title":"Systematic pain assessment in horses","author":"JC De Grauw","year":"2015","journal-title":"Vet J"},{"key":"pone.0255618.ref003","doi-asserted-by":"crossref","DOI":"10.3390\/ani10020210","article-title":"In-person caretaker visits disrupt ongoing discomfort behavior in hospitalized equine","volume":"10","author":"C Torcivia","year":"2020","journal-title":"Animals"},{"key":"pone.0255618.ref004","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1111\/j.1467-2995.2009.00521.x","article-title":"Analgesic efficacy of intra-articular morphine in experimentally induced radiocarpal synovitis in horses","volume":"37","author":"C Lindegaard","year":"2010","journal-title":"Vet Anaesth Analg"},{"key":"pone.0255618.ref005","doi-asserted-by":"crossref","first-page":"565","DOI":"10.2746\/042516405775314826","article-title":"Behavioural assessment of pain in horses and donkeys: application to clinical practice and future studies","volume":"37","author":"FH Ashley","year":"2005","journal-title":"Equine Vet J"},{"key":"pone.0255618.ref006","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.tvjl.2013.04.007","article-title":"Validation of two behaviour-based pain scales for horses with acute colic","volume":"197","author":"GA Sutton","year":"2013","journal-title":"Vet J"},{"key":"pone.0255618.ref007","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.tvjl.2012.10.008","article-title":"A behaviour-based pain scale for horses with acute colic: Scale construction","volume":"196","author":"Abells G Sutton","year":"2013","journal-title":"Vet J"},{"key":"pone.0255618.ref008","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.rvsc.2007.10.011","article-title":"Development of a composite orthopaedic pain scale in horses","volume":"85","author":"G Bussi\u00e8res","year":"2008","journal-title":"Res Vet Sci"},{"key":"pone.0255618.ref009","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.tvjl.2019.02.001","article-title":"Pain assessment in horses after orthopaedic surgery and with orthopaedic trauma","volume":"246","author":"JPAM van Loon","year":"2019","journal-title":"Vet J"},{"key":"pone.0255618.ref010","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0092281","article-title":"Development of the Horse Grimace Scale (HGS) as a pain assessment tool in horses undergoing routine castration","volume":"9","author":"E Dalla Costa","year":"2014","journal-title":"PLoS One"},{"key":"pone.0255618.ref011","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.tvjl.2015.08.023","article-title":"Monitoring acute equine visceral pain with the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS-COMPASS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP): A scale-construction study","volume":"206","author":"JPAM van Loon","year":"2015","journal-title":"Vet J"},{"key":"pone.0255618.ref012","doi-asserted-by":"crossref","DOI":"10.1186\/s12917-015-0395-8","article-title":"Refinement and partial validation of the UNESP-Botucatu multidimensional composite pain scale for assessing postoperative pain in horses","volume":"11","author":"MO Taffarel","year":"2015","journal-title":"BMC Vet Res"},{"key":"pone.0255618.ref013","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jveb.2017.10.008","article-title":"Development of an ethogram for a pain scoring system in ridden horses and its application to determine the presence of musculoskeletal pain","volume":"23","author":"S Dyson","year":"2018","journal-title":"J Vet Behav Clin Appl Res"},{"key":"pone.0255618.ref014","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1111\/vaa.12212","article-title":"An equine pain face","volume":"42","author":"KB Gleerup","year":"2015","journal-title":"Vet Anaesth Analg"},{"key":"pone.0255618.ref015","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1016\/j.jevs.2010.09.011","article-title":"Application of a composite pain scale to objectively monitor horses with somatic and visceral pain under hospital conditions","volume":"30","author":"JPAM van Loon","year":"2010","journal-title":"J Equine Vet Sci"},{"key":"pone.0255618.ref016","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.tvjl.2019.01.004","article-title":"Comparison of three acute colic pain scales: Reliability, validity and usability","volume":"246","author":"GA Sutton","year":"2019","journal-title":"Vet J"},{"key":"pone.0255618.ref017","doi-asserted-by":"crossref","first-page":"9","DOI":"10.3390\/ani6080047","article-title":"Using the Horse Grimace Scale (HGS) to assess pain associated with acute laminitis in horses","volume":"6","author":"E dalla Costa","year":"2016","journal-title":"Animals"},{"key":"pone.0255618.ref018","doi-asserted-by":"crossref","first-page":"2242","DOI":"10.3390\/ani10122242","article-title":"Prospective feasibility and revalidation of the Equine Acute Abdominal Pain Scale (EAAPS) in clinical cases of colic in horses","volume":"10","author":"Y Maskato","year":"2020","journal-title":"Animals"},{"key":"pone.0255618.ref019","doi-asserted-by":"crossref","DOI":"10.1093\/med\/9780199685219.001.0001","volume-title":"Health measurement scales: a practical guide to their development and use","author":"DL Streiner","year":"2015","edition":"5"},{"key":"pone.0255618.ref020","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.3390\/ani11061629","article-title":"Spontaneous behaviors of post-orchiectomy pain in horses regardless of the effects of time of day, anesthesia, and analgesia","volume":"11","author":"PHE Trindade","journal-title":"Animals"},{"key":"pone.0255618.ref021","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1186\/s12917-014-0200-0","article-title":"Validation of the UNESP-Botucatu unidimensional composite pain scale for assessing postoperative pain in cattle","volume":"10","author":"FA Oliveira","year":"2014","journal-title":"BMC Vet Res"},{"key":"pone.0255618.ref022","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1186\/1746-6148-9-143","article-title":"Validation of the English version of the UNESP-Botucatu multidimensional composite pain scale for assessing post-operative pain in cats","volume":"9","author":"JT Brondani","year":"2013","journal-title":"BMC Vet Res"},{"key":"pone.0255618.ref023","first-page":"1","article-title":"Validation of the UNESP-Botucatu pig composite acute pain scale (UPAPS)","volume":"15","author":"SPL Luna","year":"2020","journal-title":"PLoS One"},{"key":"pone.0255618.ref024","article-title":"Validation of the Unesp-Botucatu composite scale to assess acute postoperative abdominal pain in sheep (USAPS)","volume":"15","author":"NEOF Silva","year":"2020","journal-title":"PLoS One"},{"key":"pone.0255618.ref025","doi-asserted-by":"crossref","first-page":"174","DOI":"10.2460\/ajvr.72.2.174","article-title":"Refinement and initial validation of a multidimensional composite scale for use in assessing acute post-operative pain in cats","volume":"72","author":"JT Brondani","year":"2011","journal-title":"Am J Vet Res"},{"key":"pone.0255618.ref026","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/BF02289233","article-title":"The varimax criterion for analytic rotation in factor analysis","volume":"23","author":"HF Kaiser","year":"1958","journal-title":"Psychometrika"},{"key":"pone.0255618.ref027","volume-title":"Practical Statistics for Medical Research","author":"D Altman","year":"1991"},{"key":"pone.0255618.ref028","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1177\/0013164403260197","article-title":"A Note on the interpretation of weighted kappa and its relations to other rater agreement statistics for metric scales","volume":"64","author":"C Schuster","year":"2004","journal-title":"Educ Psychol Meas"},{"key":"pone.0255618.ref029","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"JR Landis","year":"1977","journal-title":"Biometrics"},{"key":"pone.0255618.ref030","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1037\/h0026256","article-title":"Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit","volume":"70","author":"J Cohen","year":"1968","journal-title":"Psychol Bull"},{"key":"pone.0255618.ref031","first-page":"404","volume-title":"Practical Statistics for Medical Research","author":"D Altman","year":"1991"},{"key":"pone.0255618.ref032","volume-title":"Scale development: theory and applications","author":"RF DeVellis","year":"2017","edition":"4"},{"key":"pone.0255618.ref033","first-page":"922","volume-title":"Psychometric properties of a German version of the neck pain and disability scale","author":"M Scherer","year":"2008"},{"key":"pone.0255618.ref034","doi-asserted-by":"crossref","first-page":"142S","DOI":"10.1016\/S0197-2456(05)80019-4","article-title":"Reproducibility and responsiveness of health status measures. Statistics and strategies for evaluation","volume":"12","author":"RA Deyo","year":"1991","journal-title":"Control Clin Trials"},{"key":"pone.0255618.ref035","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1177\/070674370705200210","article-title":"What\u2019s under the ROC? An introduction to receiver operating characteristics curves","volume":"52","author":"DL Streiner","year":"2007","journal-title":"Can J Psychiatry"},{"key":"pone.0255618.ref036","first-page":"203","article-title":"Measures of diagnostic accuracy: basic definitions","volume":"19","author":"A-M \u0160imundi\u0107","year":"2009","journal-title":"EJIFCC"},{"key":"pone.0255618.ref037","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1207\/S15327752JPA8001_18","article-title":"Starting at the beginning: An introduction to coefficient alpha and internal consistency","volume":"80","author":"DL Streiner","year":"2003","journal-title":"J Pers Assess"},{"key":"pone.0255618.ref038","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.applanim.2005.06.012","article-title":"Training in behaviour-based post-operative pain scoring in rats\u2014An evaluation based on improved recognition of analgesic requirements","volume":"96","author":"JV. Roughan","year":"2006","journal-title":"Appl Anim Behav Sci"},{"key":"pone.0255618.ref039","doi-asserted-by":"crossref","first-page":"61","DOI":"10.2460\/javma.1998.212.01.61","article-title":"Comparison of three methods used for assessment of pain in dogs","volume":"212","author":"LL Holton","year":"1998","journal-title":"J Am Vet Med Assoc"},{"issue":"6","key":"pone.0255618.ref040","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1016\/j.anbehav.2009.09.014","article-title":"Can you believe my eyes? The importance of interobserver reliability statistics in observations of animal behaviour","volume":"78","author":"AB Kaufman","year":"2009","journal-title":"Anim. Behav"},{"key":"pone.0255618.ref041","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1111\/j.1532-5415.2000.tb03881.x","article-title":"The geriatric pain measure: Validity, reliability and factor analysis","volume":"48","author":"BA Ferrell","year":"2000","journal-title":"J Am Geriatr Soc"},{"key":"pone.0255618.ref042","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/01.PCC.0000257098.32268.AA","article-title":"Validity and reliability of the behavioural observational pain scale for post-operative pain measurement in children 1\u20137 years of age","volume":"8","author":"K Hesselgard","year":"2007","journal-title":"Pediatr Crit Care Med"},{"key":"pone.0255618.ref043","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1053\/eujp.1999.0118","article-title":"The development of the DEGR(R): A scale to assess pain in young children with cancer","volume":"3","author":"Rodary Gauvain-Piquard","year":"1999","journal-title":"Eur J Pain"},{"key":"pone.0255618.ref044","doi-asserted-by":"crossref","first-page":"II84","DOI":"10.1097\/00005650-200009002-00013","article-title":"Longitudinal construct validity: establishment of clinical meaning in patient evaluative instruments","volume":"38","author":"MH Liang","year":"2000","journal-title":"Med Care"},{"key":"pone.0255618.ref045","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1111\/j.1365-2885.1986.tb00009.x","article-title":"Absorption and pharmacokinetics of phenylbutazone in Welsh Mountain ponies","volume":"9","author":"TE Maitho","year":"1986","journal-title":"J Vet Pharmacol Ther"},{"key":"pone.0255618.ref046","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1111\/j.2042-3306.1981.tb03472.x","article-title":"Pharmacokinetics of phenylbutazone and its metabolites in the horse","volume":"13","author":"EL Gerring","year":"1981","journal-title":"Equine Vet J"},{"key":"pone.0255618.ref047","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/0168-1591(93)90116-7","article-title":"Use of physiological measures to assess individual differences in reactivity","volume":"37","author":"X Manteca","year":"1993","journal-title":"Appl Anim Behav Sci"},{"key":"pone.0255618.ref048","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/0168-1591(88)90001-9","article-title":"Normal and more highly reactive horses. I. Heart rate, respiration rate and behavioral observations","volume":"19","author":"JS McCann","year":"1988","journal-title":"Appl Anim Behav Sci"},{"key":"pone.0255618.ref049","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.tvjl.2014.01.003","article-title":"Monitoring equine visceral pain with a composite pain scale score and correlation with survival after emergency gastrointestinal surgery","volume":"200","author":"JPAM Van Loon","year":"2014","journal-title":"Vet J"},{"key":"pone.0255618.ref050","volume-title":"Standards for educational and psychological testing","author":"American Educational Research Association","year":"2014"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0255618","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T22:22:34Z","timestamp":1725574954000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0255618"}},"subtitle":[],"editor":[{"given":"Antonio Humberto Hamad","family":"Minervino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,8,5]]},"references-count":50,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,8,5]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0255618","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,5]]}}}