Tim Nuttall1, Emmanuel Bensignor. 1. The Royal (Dick) School of Veterinary Studies, Easter Bush Veterinary Centre, University of Edinburgh, Roslin, EH25 9RG, UK.
Abstract
BACKGROUND: The lack of an accepted clinical scoring system in canine otitis externa makes it difficult to compare clinical trials. HYPOTHESIS/ OBJECTIVES: To develop a score that is clinically relevant, reliable and sensitive to change. ANIMALS: Client-owned healthy dogs (n = 55) and dogs with otitis externa (n = 60). METHODS: We compared 0-3 and 0-5 assessments of erythema, oedema/swelling, erosion/ulceration, exudate and pain of the ear canals with a reference 0-2 scale. Additional data included odour, pruritus scores, tympanic membrane condition, treatment outcome and neutrophil, bacterial and Malassezia counts. RESULTS: There were no significant differences between the vertical and horizontal canal scores (correlation coefficients >0.93). Correlation coefficients for the 0-3 and 0-5 scales were also >0.9 for all parameters, but the 0-2 scale was more variable. Pain and pruritus did not correlate well with the lesion scores and were associated with suppurative and erythroceruminous otitis, respectively. Neutrophil and microbial counts were variable and could not be used to generate cut-off values to differentiate healthy and affected ears or determine the response to therapy. Total scores ≥4 differentiated affected from healthy ears with 91.1% sensitivity and 100% specificity; scores ≤3 were 100% sensitive and 91.9% specific for clinical success. The intra- and interobserver reliability was high (intraclass correlation coefficients >0.95 and Cohen's kappa coefficients >0.65). CONCLUSIONS AND CLINICAL IMPORTANCE: This pilot study showed that the 0-3 Otitis Index Score (OTIS3) for erythema, oedema/swelling, erosion/ulceration and exudate is suitable for further validation by a larger group of clinicians.
BACKGROUND: The lack of an accepted clinical scoring system in canineotitis externa makes it difficult to compare clinical trials. HYPOTHESIS/ OBJECTIVES: To develop a score that is clinically relevant, reliable and sensitive to change. ANIMALS: Client-owned healthy dogs (n = 55) and dogs with otitis externa (n = 60). METHODS: We compared 0-3 and 0-5 assessments of erythema, oedema/swelling, erosion/ulceration, exudate and pain of the ear canals with a reference 0-2 scale. Additional data included odour, pruritus scores, tympanic membrane condition, treatment outcome and neutrophil, bacterial and Malassezia counts. RESULTS: There were no significant differences between the vertical and horizontal canal scores (correlation coefficients >0.93). Correlation coefficients for the 0-3 and 0-5 scales were also >0.9 for all parameters, but the 0-2 scale was more variable. Pain and pruritus did not correlate well with the lesion scores and were associated with suppurative and erythroceruminous otitis, respectively. Neutrophil and microbial counts were variable and could not be used to generate cut-off values to differentiate healthy and affected ears or determine the response to therapy. Total scores ≥4 differentiated affected from healthy ears with 91.1% sensitivity and 100% specificity; scores ≤3 were 100% sensitive and 91.9% specific for clinical success. The intra- and interobserver reliability was high (intraclass correlation coefficients >0.95 and Cohen's kappa coefficients >0.65). CONCLUSIONS AND CLINICAL IMPORTANCE: This pilot study showed that the 0-3 Otitis Index Score (OTIS3) for erythema, oedema/swelling, erosion/ulceration and exudate is suitable for further validation by a larger group of clinicians.
Authors: Riitta T K Seppänen; Mirja Kaimio; Kirsti J M Schildt; Liisa Lilja-Maula; Heli K Hyytiäinen; Sari Mölsä; Mikael Morelius; Minna M Rajamäki; Anu K Lappalainen; Merja Rantala Journal: Vet Dermatol Date: 2019-04-29 Impact factor: 1.589
Authors: Cristina Vercelli; Mario Pasquetti; Giovanni Giovannetti; Sara Visioni; Giovanni Re; Mario Giorgi; Graziana Gambino; Andrea Peano Journal: J Vet Pharmacol Ther Date: 2021-07-13 Impact factor: 1.567