Peer-reviewed veterinary case report
Inter-observer agreement of canine and feline paroxysmal event semiology and classification by veterinary neurology specialists and non-specialists.
- Journal:
- BMC veterinary research
- Year:
- 2015
- Authors:
- Packer, Rowena M A et al.
- Affiliation:
- Department of Clinical Science and Services · United Kingdom
Plain-English summary
This study looked at how well veterinarians agree on interpreting videos of dogs and cats having unusual episodes, which could be seizures or other events. They found that there was only a fair agreement on whether a seizure was present and a moderate agreement on the type of seizure. However, there was poor agreement on other important details, like the animal's awareness during the episode and certain behaviors. The researchers concluded that more training is needed for veterinarians, especially those who are not specialists in neurology, to improve the accuracy of diagnosing these events. Overall, the study suggests that better tools and discussions among experts are necessary to help differentiate between seizures and other types of episodes.
Abstract
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.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/25881213/