Abstract
This study investigated inter-rater reliability, agreement, and responsiveness of the Feline Grimace Scale (FGS) scores in brachycephalic cats.
Twenty-eight brachycephalic cats (6.6 ± 4.4 years; 4.2 ± 1.0 kg) undergoing ocular surgery were included in a prospective, randomized, blinded study. Ninety-five cat face images collected from video recordings pre- and postoperatively (before/after analgesia) were scored by four raters using the FGS and compared with real-time scores during pain assessment. Limits of agreement (LoAs) and bias were evaluated using the Bland-Altman method (good or poor agreement if bias <0.1 or >0.1, respectively). Inter-rater reliability was assessed using the intraclass correlation coefficient (ICC, <0.50 = poor; 0.50–0.75 = moderate; 0.76–0.90 = good; and >0.90 = excellent reliability. Generalized linear mixed models evaluated FGS responsiveness (P <0.05).
Inter-rater reliability (ICCsingle, 95%, confidence intervals) was poor for muzzle (0.47; 0.36–0.58) and whiskers (0.34; 0.22–0.46), good for ears (0.81; 0.74–0.86) and eyes (0.84; 0.79–0.88), moderate for head position (0.71; 0.59–0.79) and excellent for FGS total ratio scores (0.92; 0.89–0.94). LoAs ranged from -0.37 to 0.22 with bias of -0.08; suggesting that some cats could have their scores affected in comparison with real-time scores. FGS total scores decreased after analgesia pre- (0.56 ± 0.10 vs. 0.38 ± 0.15, P = 0.005) and postoperatively (0.60 ± 0.18 vs. 0.36 ± 0.15, P <0.001).
The FGS is a responsive pain scoring instrument in brachycephalic cats, with good agreement among raters, and excellent inter-rater reliability for total ratio scores. Pain may be underestimated using image assessment in brachycephalic cats.
Twenty-eight brachycephalic cats (6.6 ± 4.4 years; 4.2 ± 1.0 kg) undergoing ocular surgery were included in a prospective, randomized, blinded study. Ninety-five cat face images collected from video recordings pre- and postoperatively (before/after analgesia) were scored by four raters using the FGS and compared with real-time scores during pain assessment. Limits of agreement (LoAs) and bias were evaluated using the Bland-Altman method (good or poor agreement if bias <0.1 or >0.1, respectively). Inter-rater reliability was assessed using the intraclass correlation coefficient (ICC, <0.50 = poor; 0.50–0.75 = moderate; 0.76–0.90 = good; and >0.90 = excellent reliability. Generalized linear mixed models evaluated FGS responsiveness (P <0.05).
Inter-rater reliability (ICCsingle, 95%, confidence intervals) was poor for muzzle (0.47; 0.36–0.58) and whiskers (0.34; 0.22–0.46), good for ears (0.81; 0.74–0.86) and eyes (0.84; 0.79–0.88), moderate for head position (0.71; 0.59–0.79) and excellent for FGS total ratio scores (0.92; 0.89–0.94). LoAs ranged from -0.37 to 0.22 with bias of -0.08; suggesting that some cats could have their scores affected in comparison with real-time scores. FGS total scores decreased after analgesia pre- (0.56 ± 0.10 vs. 0.38 ± 0.15, P = 0.005) and postoperatively (0.60 ± 0.18 vs. 0.36 ± 0.15, P <0.001).
The FGS is a responsive pain scoring instrument in brachycephalic cats, with good agreement among raters, and excellent inter-rater reliability for total ratio scores. Pain may be underestimated using image assessment in brachycephalic cats.
© by the individual authors/speakers.
| Original language | English |
|---|---|
| Title of host publication | World Feline Congress 2025 |
| Subtitle of host publication | Veterinary Proceedings |
| Pages | 113 |
| Publication status | Published - Jun 2025 |
| Event | World Feline Congress 2025: Advancing the Wellbeing of Cats through Medicine and Management - Edinburgh International Conference Centre, Edinburgh, United Kingdom Duration: 27 Jun 2025 → 29 Jun 2025 https://icatcare.org/events/world-feline-congress-2025 |
Conference
| Conference | World Feline Congress 2025 |
|---|---|
| Place | United Kingdom |
| City | Edinburgh |
| Period | 27/06/25 → 29/06/25 |
| Internet address |