Variability in the interpretation of survey radiographs among veterinarians

Substantial variability exists in the interpretation of survey radiographs among equine veterinarians

Equine Vet J. 2024 Jan 9. doi: 10.1111/evj.14045. Online ahead of print.
Authors
Angie M Esselman 1 , Sherry A Johnson 2 , David D Frisbie 1 , Myra F Barrett 3 , Tianjian Zhou 4 , Erin K Contino 1
Affiliations

1 Department of Clinical Sciences, Orthopaedic Research Center at the Translational Medicine Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
2 Equine Sports Medicine, Pilot Point, Texas, USA.
3 Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
4 Department of Statistics, College of Natural Resources, Colorado State University, Fort Collins, Colorado, USA.

PMID: 38194693
DOI: 10.1111/evj.14045

Abstract

Background: Radiographs are a common diagnostic tool utilised during pre-purchase examinations, yet differences surround their interpretation among equine veterinarians.

Objectives: (1) To determine veterinarians’ subjective impressions of a spectrum of radiographic abnormalities regarding suitability for purchase; (2) To determine how veterinarians’ years in practice, primary discipline or board certification status influence their subjective impression of radiographic abnormalities, and (3) To determine how horses’ discipline, current level of work (working at intended level vs. future prospect) and buyer intent (sell vs. retain ownership) influence veterinarians’ subsequent recommendation.

Study design: Worldwide electronic survey of veterinary professionals.

Methods: Four radiographic series of navicular bones, tarsi, and stifles, representing varying degrees of pathological change (normal, mild, moderate and marked) were presented. Respondents (n = 211) graded their level of concern from 1 (no concern) to 10 (very concerned) based on the radiographs and case scenarios presented.

Results: Overall, as the grade of pathological change increased for each anatomical location, so did the level of veterinarian concern, but a wide range of answers were submitted for all grades of pathology. Board certified practitioners had a higher level of concern over marked radiographic changes of the navicular bone for both western performance and English sport horses as well as prospect horses (mean = 7.2 vs. 6.1; P = 0.009; 95% CI for difference = [0.3, 2.0]). Board certified respondents had a lower level of concern over marked radiographic changes of the tarsus regardless of the performance status of the horse (mean = 7.1 vs. 8.0; P = 0.008; 95% CI for difference = [-1.5, -0.2]). Western performance horse practitioners had a lower level of concern over mild radiographic changes of the tarsus regardless of the performance status of the horse (mean = 3.3 vs. 4.2; P = 0.009; 95% CI for difference = [-1.6, -0.2]).

Main limitations: Only one example of each pathological grade per anatomical region was presented.

Conclusions: On survey radiographs, the perceived clinical relevance of radiographic abnormalities among equine practitioners differs widely, making purchase recommendations highly variable.

Keywords: horse; pre-purchase; radiograph; survey.