Multilingual validation of the short form of the Unesp-Botucatu Feline Pain Scale (UFEPS-SF)

Abstract

Background Pain is the leading cause of animal suffering, hence the importance of validated tools to ensure its appropriate evaluation and treatment. We aimed to test the psychometric properties of the short form of the Unesp-Botucatu Feline Pain Scale (UFEPS-SF) in eight languages. Methods The original scale was condensed from ten to four items. The content validation was performed by five specialists in veterinary anesthesia and analgesia. The English version of the scale was translated and back-translated into Chinese, French, German, Italian, Japanese, Portuguese and Spanish by fluent English and native speaker translators. Videos of the perioperative period of 30 cats submitted to ovariohysterectomy (preoperative, after surgery, after rescue analgesia and 24 h after surgery) were randomly evaluated twice (one-month interval) by one evaluator for each language unaware of the pain condition. After watching each video, the evaluators scored the unidimensional, UFEPS-SF and Glasgow composite multidimensional feline pain scales. Statistical analyses were carried out using R software for intra and interobserver reliability, principal component analysis, criteria concurrent and predictive validities, construct validity, item-total correlation, internal consistency, specificity, sensitivity, the definition of the intervention score for rescue analgesia and diagnostic uncertainty zone, according to the receiver operating characteristic (ROC) curve. Results UFEPS-SF intra- and inter-observer reliability were ≥0.92 and 0.84, respectively, for all observers. According to the principal component analysis, UFEPS-SF is a unidimensional scale. Concurrent criterion validity was confirmed by the high correlation between UFEPS-SF and all other scales (≥0.9). The total score and all items of UFEPS-SF increased after surgery (pain), decreased to baseline after analgesia and were intermediate at 24 h after surgery (moderate pain), confirming responsiveness and construct validity. Item total correlation of each item (0.68–0.83) confirmed that the items contributed homogeneously to the total score. Internal consistency was excellent (≥0.9) for all items. Both specificity (baseline) and sensitivity (after surgery) based on the Youden index was 99% (97–100%). The suggestive cut-off score for the administration of analgesia according to the ROC curve was ≥4 out of 12. The diagnostic uncertainty zone ranged from 3 to 4. The area under the curve of 0.99 indicated excellent discriminatory capacity of UFEPS-SF. Conclusions The UFEPS-SF and its items, assessed by experienced evaluators, demonstrated very good repeatability and reproducibility, content, criterion and construct validities, item-total correlation, internal consistency, excellent sensitivity and specificity and a cut-off point indicating the need for rescue analgesia in Chinese, French, English, German, Italian, Japanese, Portuguese and Spanish.

Validation of the rabbit pain behaviour scale (RPBS) to assess acute postoperative pain in rabbits (Oryctolagus cuniculus)

“…Assessing how observers with different backgrounds and cultures assess the scale was not the aim of this study. This is an initial study for the validation of the RPBS, which should be subsequently submitted to cross-cultural validity [ 26 ], including evaluators with different backgrounds and ethnicities or languages, as performed for other scales after their validation [ 77 , 78 ]. The evaluators who use the RPBS should carry out prior training to ensure the reliability and validity of the results until a further evaluation is performed with the RPBS used by evaluators without training.…”

Improving Ovine Behavioral Pain Diagnosis by Implementing Statistical Weightings Based on Logistic Regression and Random Forest Algorithms

“…Therefore, in order not to neglect these particularities, we chose to use expert opinion throughout the four perioperative time points. To the best of our knowledge, the expert opinion currently appears to provide the best possible results for determining animals with pain from pain-free animals [ 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ], but we recognize that this is still a challenge that requires attention.…”

“…Finally, weighting could be implemented in the future in recently validated instruments for pain assessment that use full body language and/or the face in other non-human mammals such as felines [ 56 , 57 , 61 , 62 , 74 ], bovines [ 63 , 64 ], swine [ 65 , 75 ], horses [ 66 , 67 ], donkeys [ 58 , 68 ], and lagomorphs [ 59 , 60 ].…”

2022 WSAVA guidelines for the recognition, assessment and treatment of pain

“…It is now accepted that observations made by an observer that take behaviour, body posture and facial expressions into account are most likely to capture the complex experience of an animal's pain. Multi-dimensional composite pain scales for assessing postoperative pain in cats are available including the UNESP-Botucatu multi-dimensional feline pain assessment scale -short form (UFEPS-SF) (Belli et al 2021, Luna et al 2022) (see https://animalpain.org/en/home-en/), and the Glasgow composite measure pain scale-Feline (CMPS-Feline) (Reid et al 2017) (Table 4). These tools require interaction with the patient, which is not always possible (e.g.…”

“…The maximum score is 12. Cut-off score for rescue analgesia: ≥4/12 ‡ Available at: http://www.animalpain.org (Belli et al 2021, Luna et al 2022, Brondani et al 2013 Glasgow…”