Highlights of recent clinically relevant papers

Abstract

Highlights of recent clinically relevant papers Quantitative gait analysisThe aims of this clinical observational study by Aagje Hardeman and co-workers in the Netherlands and Sweden were to investigate between-and within-veterinarian agreement on primary lame limb and lameness grade, and to determine relationships between subjective lameness grade and quantitative data, focusing on differences between (1) veterinarians, (2) live versus video assessment, (3) baseline assessment versus assessment following diagnostic analgesia.Kinematic data were compared with subjective lameness assessment by clinicians with ≥8 years of orthopaedic experience. Subjective assessments and kinematic data for baseline trot-ups and response to 48 diagnostic analgesia interventions in 23 cases were included. Between-and withinveterinarian agreement was investigated using Cohen's Kappa (j). Asymmetry parameters for kinematic data ('forelimb lame pattern', 'hindlimb lame pattern', 'overall symmetry', 'vector sum head' and 'pelvic sum') were determined and used as outcome variables in mixed models; explanatory variables were subjective lameness grade and its interaction with (1) veterinarian, (2) live or video evaluation and (3) baseline or diagnostic analgesia assessment.Agreement on lame limb between live and video assessment was 'good' between and within veterinarians. There was a positive correlation between subjective scoring and measured asymmetry. The relationship between lameness grade and objective asymmetry differed slightly between (1) veterinarians (for all combined parameters), (2) between live and video assessments ('forelimb lame pattern' and 'overall symmetry') and (3) between baseline and diagnostic analgesia assessment (all combined parameters).Overall, between-and within-veterinarian agreement on lame limb was 'good', whereas agreement on lameness grade was 'acceptable' to 'poor'. Quantitative data and subjective assessments correlated well, with minor though significant differences in the number of millimetres, equivalent to one lameness grade between veterinarians and between assessment conditions. Differences between baseline assessment versus assessment following diagnostic analgesia suggest that the addition of objective data can be beneficial to reduce expectation bias.