{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,8]],"date-time":"2025-03-08T05:24:38Z","timestamp":1741411478485,"version":"3.38.0"},"reference-count":37,"publisher":"American Veterinary Medical Association (AVMA)","issue":"1","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>To assess intraobserver and interobserver reliability of capillary refill time (CRT) measurement in dogs using a standardized technique after training.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>ANIMALS<\/jats:title>\n<jats:p>20 dogs presented to the emergency room.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Dogs presented to the emergency room were prospectively recruited. Using a timing device and standardized technique, CRT was measured at the oral mucosa of the inner lip. Measurements were performed by 2 emergency and critical care residents (observer 1 [Ob1] and observer 2 [Ob2]) and repeated 3 times by each observer for each dog. CRT values and signalment were recorded. Intraobserver and interobserver reliability were analyzed by calculation of the coefficient of variation (CV%), intraclass correlation coefficient (ICC), and minimal detectable difference. Reliability was considered high if CV% was lower than 10% and ICC was between 0.9 and 1.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Median CRT for Ob1 was 1.22 seconds and for Ob2 was 1.19 seconds. Intraobserver reliability was high, evidenced by a median CV% of 6.2% (range, 1.0% to 18.6%) and 9.5% (range, 1.3% to 22.6%) and an ICC of 0.97 (95% CI, 0.94 to 0.99) and 0.95 (95% CI, 0.90 to 0.98) for Ob1 and Ob2, respectively. Between observers, the CV% was 4.4% (range, 0.8% to 17.5%) and the ICC was 0.98 (95% CI, 0.94 to 0.99), indicating high interobserver reliability. The minimal detectable differences for intraobserver and interobserver were 0.30 and 0.34 seconds, respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CLINICAL RELEVANCE<\/jats:title>\n<jats:p>The reported high reliability of CRT despite its subjective nature enhances its usefulness in daily practice. However, further research on the validity of CRT is warranted.<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/javma.23.07.0417","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T15:13:46Z","timestamp":1695827626000},"page":"72-78","source":"Crossref","is-referenced-by-count":0,"title":["Intraobserver and interobserver reliability of standardized capillary refill time in dogs is high following observer training"],"prefix":"10.2460","volume":"262","author":[{"given":"Aina","family":"Claret","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Gelendi","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kendon","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen","family":"McMichael","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Gerken","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pen-Ting","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1272","reference":[{"issue":"3","key":"ref1","series-title":"Top Companion Anim Med","first-page":"86","article-title":"Practical assessment of volume status in daily practice","volume":"31","author":"Johnson P","year":"2016","unstructured":"Johnson P. Practical assessment of volume status in daily practice. Top Companion Anim Med. 2016;31(3):86\u201393. doi:10.1053\/j.tcam.2016.08.002"},{"issue":"1","key":"ref2","series-title":"Anesth Analg","first-page":"120","article-title":"Capillary refill time: is it still a useful clinical sign?","volume":"113","author":"Pickard A","year":"2011","unstructured":"Pickard A, Karlen W, Ansermino JM. Capillary refill time: is it still a useful clinical sign? Anesth Analg. 2011;113(1):120\u2013123. doi:10.1213\/ANE.0b013e31821569f9"},{"issue":"7","key":"ref3","series-title":"Intensive Care Med","first-page":"958","article-title":"Capillary refill time exploration during septic shock","volume":"40","author":"Ait-Oufella H","year":"2014","unstructured":"Ait-Oufella H, Bige N, Boelle PY,  Capillary refill time exploration during septic shock. Intensive Care Med. 2014;40(7):958\u2013964. doi:10.1007\/s00134-014-3326-4"},{"issue":"11","key":"ref4","series-title":"PLoS One","first-page":"e0188548","article-title":"Capillary refill time during fluid resuscitation in patients with sepsis-related hyperlactatemia at the emergency department is related to mortality","volume":"12","author":"Lara B","year":"2017","unstructured":"Lara B, Enberg L, Ortega M,  Capillary refill time during fluid resuscitation in patients with sepsis-related hyperlactatemia at the emergency department is related to mortality. PLoS One. 2017;12(11):e0188548. doi:10.1371\/journal.pone.0188548"},{"issue":"3","key":"ref5","series-title":"Crit Care Med","first-page":"934","article-title":"The prognostic value of the subjective assessment of peripheral perfusion in critically ill patients","volume":"37","author":"Lima A","year":"2009","unstructured":"Lima A, Jansen TC, van Bommel J, Ince C, Bakker J. The prognostic value of the subjective assessment of peripheral perfusion in critically ill patients. Crit Care Med. 2009;37(3):934\u2013938. doi:10.1097\/CCM.0b013e31819869db"},{"issue":"3","key":"ref6","series-title":"Crit Care","first-page":"R114","article-title":"Clinical assessment of peripheral perfusion to predict postoperative complications after major abdominal surgery early: a prospective observational study in adults","volume":"18","author":"van Genderen ME","year":"2014","unstructured":"van Genderen ME, Paauwe J, de Jonge J,  Clinical assessment of peripheral perfusion to predict postoperative complications after major abdominal surgery early: a prospective observational study in adults. Crit Care. 2014;18(3):R114. doi:10.1186\/cc13905"},{"issue":"1","key":"ref7","series-title":"Ann Intensive Care","first-page":"74","article-title":"Kinetics of capillary refill time after fluid challenge","volume":"12","author":"Raia L","year":"2022","unstructured":"Raia L, Gabarre P, Bonny V,  Kinetics of capillary refill time after fluid challenge. Ann Intensive Care. 2022;12(1):74. doi:10.1186\/s13613-022-01049-x"},{"issue":"5","key":"ref8","series-title":"J Vet Emerg Crit Care (San Antonio)","first-page":"585","article-title":"Standardized capillary refill time and relation to clinical parameters in hospitalized dogs","volume":"31","author":"Chalifoux NV","year":"2021","unstructured":"Chalifoux NV, Spielvogel CF, Stefanovski D, Silverstein DC. Standardized capillary refill time and relation to clinical parameters in hospitalized dogs. J Vet Emerg Crit Care (San Antonio). 2021;31(5):585\u2013594. doi:10.1111\/vec.13088"},{"issue":"7","key":"ref9","series-title":"J Clin Epidemiol","first-page":"737","article-title":"The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes","volume":"63","author":"Mokkink LB","year":"2010","unstructured":"Mokkink LB, Terwee CB, Patrick DL,  The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010;63(7):737\u2013745. doi:10.1016\/j.jclinepi.2010.02.006"},{"issue":"10","key":"ref10","series-title":"Mayo Clin Proc","first-page":"1244","article-title":"Clinical Significance Consensus Meeting Group. Precision of health-related quality-of-life data compared with other clinical measures","volume":"82","author":"Hahn EA","year":"2007","unstructured":"Hahn EA, Cella D, Chassany O, Fairclough DL, Wong GY, Hays RD; Clinical Significance Consensus Meeting Group. Precision of health-related quality-of-life data compared with other clinical measures. Mayo Clin Proc. 2007;82(10):1244\u20131254. doi:10.4065\/82.10.1244"},{"key":"ref11","series-title":"Measurement in Medicine: A Practical Guide (Practical Guides to Biostatistics and Epidemiology)","first-page":"96","article-title":"Reliability","author":"De Vet HCW","year":"2011","unstructured":"De Vet HCW, Terwee CB, Mokkink LB, Knol DL. Reliability. In: Measurement in Medicine: A Practical Guide (Practical Guides to Biostatistics and Epidemiology). Cambridge University Press; 2011:96\u2013149. doi:10.1017\/CBO9780511996214.006"},{"issue":"5","key":"ref12","series-title":"J Emerg Med","first-page":"e51","article-title":"Variability of capillary refill time among physician measurements","volume":"53","author":"Sheridan DC","year":"2017","unstructured":"Sheridan DC, Baker SD, Kayser SA, Jones D, Hansen ML. Variability of capillary refill time among physician measurements. J Emerg Med. 2017;53(5):e51\u2013e57. doi:10.1016\/j.jemermed.2017.06.035"},{"issue":"8","key":"ref13","series-title":"Emerg Med J","first-page":"465","article-title":"Man versus machine: comparison of naked-eye estimation and quantified capillary refill","volume":"36","author":"Toll John R","year":"2019","unstructured":"Toll John R, Henricson J, Anderson CD, Bj\u00f6rk Wilhelms D. Man versus machine: comparison of naked-eye estimation and quantified capillary refill. Emerg Med J. 2019;36(8):465\u2013471. doi:10.1136\/emermed-2018-207948"},{"issue":"3","key":"ref14","series-title":"Rev Bras Ter Intensiva","first-page":"269","article-title":"Lack of agreement between different observers and methods in the measurement of capillary refill time in healthy volunteers: an observational study","volume":"26","author":"Espinoza EDV","year":"2014","unstructured":"Espinoza EDV, Welsh S, Dubin A. Lack of agreement between different observers and methods in the measurement of capillary refill time in healthy volunteers: an observational study. Rev Bras Ter Intensiva. 2014;26(3):269\u2013276. doi:10.5935\/0103-507X.20140038"},{"issue":"2","key":"ref15","series-title":"Hong Kong J Emerg Med","first-page":"71","article-title":"Capillary refill time in adults has poor inter-observer agreement","volume":"15","author":"Anderson B","year":"2008","unstructured":"Anderson B, Kelly A, Kerr D, Jolley D. Capillary refill time in adults has poor inter-observer agreement. Hong Kong J Emerg Med. 2008;15(2):71\u201374. doi:10.1177\/102490790801500202"},{"issue":"21","key":"ref16","series-title":"Stat Med","first-page":"3205","article-title":"Planning a reproducibility study: how many subjects and how many replicates per subject for an expected width of the 95 per cent confidence interval of the intraclass correlation coefficient","volume":"20","author":"Giraudeau B","year":"2001","unstructured":"Giraudeau B, Mary JY. Planning a reproducibility study: how many subjects and how many replicates per subject for an expected width of the 95 per cent confidence interval of the intraclass correlation coefficient. Stat Med. 2001;20(21):3205\u20133214. doi:10.1002\/sim.935"},{"issue":"12","key":"ref17","series-title":"J Am Soc Echocardiogr","first-page":"1505","article-title":"A practical guide to assess the reproducibility of echocardiographic measurements","volume":"32","author":"Bunting KV","year":"2019","unstructured":"Bunting KV, Steeds RP, Slater LT, Rogers JK, Gkoutos GV, Kotecha D. A practical guide to assess the reproducibility of echocardiographic measurements. J Am Soc Echocardiogr. 2019;32(12):1505\u20131515. doi:10.1016\/j.echo.2019.08.015"},{"issue":"1","key":"ref18","series-title":"Ultrasound J","first-page":"22","article-title":"Intra-and inter-observer variability of point of care ultrasound measurements to evaluate hemodynamic parameters in healthy volunteers","volume":"15","author":"Blanca D","year":"2023","unstructured":"Blanca D, Schwarz EC, Olgers TJ,  Intra-and inter-observer variability of point of care ultrasound measurements to evaluate hemodynamic parameters in healthy volunteers. Ultrasound J. 2023;15(1):22. doi:10.1186\/s13089-023-00322-9"},{"issue":"2","key":"ref19","series-title":"J Chiropr Med","first-page":"155","article-title":"A guideline of selecting and reporting intraclass correlation coefficients for reliability research","volume":"15","author":"Koo TK","year":"2016","unstructured":"Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155\u2013163. doi:10.1016\/j.jcm.2016.02.012"},{"issue":"8","key":"ref20","series-title":"Phys Ther","first-page":"777","article-title":"Statistical methodology for the concurrent assessment of interrater and intrarater reliability: using goniometric measurements as an example","volume":"74","author":"Eliasziw M","year":"1994","unstructured":"Eliasziw M, Young SL, Woodbury MG, Fryday-Field K. Statistical methodology for the concurrent assessment of interrater and intrarater reliability: using goniometric measurements as an example. Phys Ther. 1994;74(8):777\u2013788. doi:10.1093\/ptj\/74.8.777"},{"issue":"3","key":"ref21","series-title":"Cardiovasc Diagn Ther","first-page":"317","article-title":"Assessing observer variability: a user\u2019s guide","volume":"7","author":"Popovi\u0107 ZB","year":"2017","unstructured":"Popovi\u0107 ZB, Thomas JD. Assessing observer variability: a user\u2019s guide. Cardiovasc Diagn Ther. 2017;7(3):317\u2013324. doi:10.21037\/cdt.2017.03.12"},{"issue":"1","key":"ref22","series-title":"BMC Emerg Med","first-page":"131","article-title":"Capillary refill time for the management of acute circulatory failure: a survey among pediatric and adult intensivists","volume":"22","author":"Jacquet-Lagr\u00e8ze M","year":"2022","unstructured":"Jacquet-Lagr\u00e8ze M, Wiart C, Schweizer R,  Capillary refill time for the management of acute circulatory failure: a survey among pediatric and adult intensivists. BMC Emerg Med. 2022;22(1):131. doi:10.1186\/s12873-022-00681-x"},{"issue":"1","key":"ref23","series-title":"Am J Emerg Med","first-page":"62","article-title":"Impact of patient and environmental factors on capillary refill time in adults","volume":"26","author":"Anderson B","year":"2008","unstructured":"Anderson B, Kelly AM, Kerr D, Clooney M, Jolley D. Impact of patient and environmental factors on capillary refill time in adults. Am J Emerg Med. 2008;26(1):62\u201365. doi:10.1016\/j.ajem.2007.06.026"},{"issue":"5","key":"ref24","series-title":"Chest","first-page":"1106","article-title":"FAMOUS Study Group*. The power of flash mob research: conducting a nationwide observational clinical study on capillary refill time in a single day","volume":"151","author":"Alsma J","year":"2017","unstructured":"Alsma J, van Saase JLCM, Nanayakkara PWB, ; FAMOUS Study Group*. The power of flash mob research: conducting a nationwide observational clinical study on capillary refill time in a single day. Chest. 2017;151(5):1106\u20131113. doi:10.1016\/j.chest.2016.11.035"},{"issue":"10","key":"ref25","series-title":"Arch Dis Child","first-page":"977","article-title":"Are bedside features of shock reproducible between different observers?","volume":"89","author":"Otieno H","year":"2004","unstructured":"Otieno H, Were E, Ahmed I, Charo E, Brent A, Maitland K. Are bedside features of shock reproducible between different observers? Arch Dis Child. 2004;89(10):977\u2013979. doi:10.1136\/adc.2003.043901"},{"issue":"1","key":"ref26","series-title":"Foot Edinb","first-page":"15","article-title":"An evaluation of the reliability and validity of capillary refill time test","volume":"17","author":"Klupp NL","year":"2007","unstructured":"Klupp NL, Keenan A-M. An evaluation of the reliability and validity of capillary refill time test. Foot Edinb. 2007;17(1):15\u201320. doi:10.1016\/j.foot.2006.08.006"},{"issue":"3","key":"ref27","series-title":"Clin Pediatr (Phila)","first-page":"139","article-title":"Capillary refill time in the hands and feet of normal newborn infants","volume":"38","author":"Raju NV","year":"1999","unstructured":"Raju NV, Maisels MJ, Kring E, Schwarz-Warner L. Capillary refill time in the hands and feet of normal newborn infants. Clin Pediatr (Phila). 1999;38(3):139\u2013144. doi:10.1177\/000992289903800303"},{"issue":"1","key":"ref28","series-title":"Am J Emerg Med","first-page":"46","article-title":"Adverse lighting condition effects on the assessment of capillary refill","volume":"12","author":"Brown LH","year":"1994","unstructured":"Brown LH, Prasad NH, Whitley TW. Adverse lighting condition effects on the assessment of capillary refill. Am J Emerg Med. 1994;12(1):46\u201347. doi:10.1016\/0735-6757(94)90196-1"},{"issue":"3","key":"ref29","series-title":"Acta Paediatr","first-page":"310","article-title":"Capillary refilling time in newborns-optimal pressing time, sites of testing and normal values","volume":"87","author":"Strozik KS","year":"1998","unstructured":"Strozik KS, Pieper CH, Cools F. Capillary refilling time in newborns-optimal pressing time, sites of testing and normal values. Acta Paediatr. 1998;87(3):310\u2013312. doi:10.1080\/08035259850157372"},{"key":"ref30","series-title":"Elements of Human Performance: Reaction Processes and Attention in Human Skill","first-page":"109","article-title":"Effects of variables","author":"Sanders AF","year":"1998","unstructured":"Sanders AF. Effects of variables. In: Elements of Human Performance: Reaction Processes and Attention in Human Skill. Lawrence Erlbaum Associates Publishers; 1998:109\u2013180."},{"key":"ref31","series-title":"Am J Emerg Med","first-page":"378","article-title":"Impact of posture on capillary refilling time","volume":"56","author":"Saito D","year":"2022","unstructured":"Saito D, Nakada TA, Imaeda T,  Impact of posture on capillary refilling time. Am J Emerg Med. 2022;56:378\u2013379. doi:10.1016\/j.ajem.2021.11.006"},{"issue":"1","key":"ref32","series-title":"BMC Anesthesiol","first-page":"30","article-title":"Agreement between capillary refill time measured at finger and earlobe sites in different positions: a pilot prospective study on healthy volunteers","volume":"23","author":"La Via L","year":"2023","unstructured":"La Via L, Sanfilippo F, Continella C,  Agreement between capillary refill time measured at finger and earlobe sites in different positions: a pilot prospective study on healthy volunteers. BMC Anesthesiol. 2023;23(1):30. doi:10.1186\/s12871-022-01920-1"},{"issue":"1","key":"ref33","series-title":"Physiol Meas","first-page":"83","article-title":"An automated quasi-continuous capillary refill timing device","volume":"37","author":"Blaxter LL","year":"2016","unstructured":"Blaxter LL, Morris DE, Crowe JA,  An automated quasi-continuous capillary refill timing device. Physiol Meas. 2016;37(1):83\u201399. doi:10.1088\/0967-3334\/37\/1\/83"},{"issue":"5","key":"ref34","series-title":"J Clin Monit Comput","first-page":"1271","article-title":"Measurement of capillary refill time with a handheld prototype device: a comparative validation study in healthy volunteers","volume":"36","author":"Ruste M","year":"2022","unstructured":"Ruste M, Cazenave L, Tardif M, Saint-Jean C, Fellahi JL, Lagr\u00e8ze MJ. Measurement of capillary refill time with a handheld prototype device: a comparative validation study in healthy volunteers. J Clin Monit Comput. 2022;36(5):1271\u20131278. doi:10.1007\/s10877-021-00757-2"},{"key":"ref35","series-title":"J Clin Monit Comput","article-title":"Reliability and reproducibility of the DICART device to assess capillary refill time: a bench and in-silico study","author":"Jacquet-Lagr\u00e8ze M","unstructured":"Jacquet-Lagr\u00e8ze M, Saint-Jean C, Bou\u00ebt T, Reynaud S, Ruste M, Fellahi JL. Reliability and reproducibility of the DICART device to assess capillary refill time: a bench and in-silico study. J Clin Monit Comput. Published online May 18, 2023. doi:10.1007\/s10877-023-01027-z"},{"key":"ref36","series-title":"Optical Diagnostics and Sensing XVIII: Toward Point-of-Care Diagnostics","first-page":"42","article-title":"Challenges in automated estimation of capillary refill time in dogs","author":"Spigulis J","year":"2018","unstructured":"Spigulis J, Cugmas B. Challenges in automated estimation of capillary refill time in dogs. In: Cot\u00e9 GL, ed. Optical Diagnostics and Sensing XVIII: Toward Point-of-Care Diagnostics. SPIE; 2018:42. doi:10.1117\/12.2284794"},{"key":"ref37","series-title":"Elife","first-page":"e35718","article-title":"Assessing reliability in neuroimaging research through intra-class effect decomposition (ICED)","volume":"7","author":"Brandmaier AM","year":"2018","unstructured":"Brandmaier AM, Wenger E, Bodammer NC, K\u00fchn S, Raz N, Lindenberger U. Assessing reliability in neuroimaging research through intra-class effect decomposition (ICED). 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