title: Variability of resting endoscopic grading for assessment of recurrent laryngeal neuropathy in horses.
abstract: BACKGROUND
  The extent to which variability affects endoscopic grading of arytenoid cartilage movement is uncertain.
  
  
  OBJECTIVE
  To determine the observer and within horse variability of grading arytenoid cartilage movement in horses during resting endoscopic examination, using a 7-grade system.
  
  
  METHODS
  Endoscopic recordings of the upper respiratory tract made at rest in 270 draught horses were reviewed independently by 2 veterinarians to assess interobserver variability when scoring horses' laryngeal function with a 7-grade system. Grading was repeated by both examiners in 80 randomly selected recordings in order to assess intraobserver variability. In 120 horses, endoscopy was repeated after 24-48 h, with videos graded by both veterinarians to assess intrahorse variability.
  
  
  RESULTS
  The mean weighted kappa statistic for concordance within examiners was 0.867, with a mean intraobserver agreement of 763%. The weighted kappa statistic for concordance between the 2 examiners was 0.765, with an interobserver agreement of 63.1%. Of the horses receiving 2 endoscopic examinations, the same grade was assigned to 57.1% of horses at the second examination, when effects resulting from interobserver variability were removed. The mean weighted kappa statistic for concordance between the grade assigned at first vs. second examinations was 0.588, indicating only moderate agreement.
  
  
  CONCLUSIONS
  Intra- and interobserver reliability of resting endoscopic grading of arytenoid cartilage movement using a 7-grade system was high when examinations were conducted by experienced veterinarians. However, there was moderate daily intrahorse variability, suggesting that results of resting endoscopic examinations performed on a single day should be interpreted with caution.
authors: Department of Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK.
authors: J D
authors: JD
authors: Perkins
authors: R O
authors: RO
authors: Salz
authors: J
authors: J
authors: Schumacher
authors: L
authors: L
authors: Livesey
authors: R J
authors: RJ
authors: Piercy
authors: S Z
authors: SZ
authors: Barakzai
mesh_terms: D000818:Animals; D004724:Endoscopy / Q000706:statistics & numerical data / Q000662:veterinary*; D006734:Horse Diseases / Q000473:pathology*; D006736:Horses; D015588:Observer Variation; D014826:Vocal Cord Paralysis / Q000145:classification / Q000473:pathology / Q000662:veterinary*