Fig 1.
Timeline of interventions, drugs and pain assessments performed for validation of the Unesp-Botucatu pig composite acute pain scale (UPAPS).
Table 1.
Description of the behaviours evaluated in the ethogram of pigs submitted to orchiectomy (adapted from the literature [6, 8, 32, 33, 34]).
Table 2.
Median and amplitude of the number of minutes/30 minutes of normal behaviours, friendly social interactions, aggressive social interactions, stereotypical behaviours, and pain-related behaviours in piglets submitted to castration (n = 40).
Table 3.
The UNESP-Botucatu composite pain scale for assessing postoperative pain in pigs.
Table 4.
Intra-observer reliability or agreement (confidence interval) for each item of the UPAPS.
Table 5.
Matrix intraclass coefficient (confidence interval 95%) of the sum of the scores of the UPAPS.
Table 6.
Inter-observer reliability (confidence interval) between the gold standard and other observers of the UPAPS.
Table 7.
Spearman correlation between the UPAPS and the Visual Analogue Scale (VAS), Numerical Rating Scale (NRS), and Simple Descriptive Scale (SDS).
Table 8.
Percentage of pigs for which rescue analgesia was indicated according to clinical experience and according to the Youden index of the UPAPS.
Fig 2.
Principal component analysis of the items of the UPAPS.
UPAPS—UNESP-Botucatu pig composite acute pain scale. Data were obtained from the gold standard observer analysis at four evaluation moments. Each number corresponds to one pig and each colour corresponds to one moment (M1—green, pigs 1 to 45; M2—red, pigs 46 to 90, correspond to pigs from 1 to 45 of M1; M3—blue, pigs 91 to 135, correspond to pigs from 1 to 45 of M1 and M4—yellow, pigs 136 to 180, correspond to pigs from 1 to 45 of M1). The ellipses were constructed according to the pain assessment moments (M2—red, M3—blue, and M4—yellow). The ellipse corresponding to the moments pigs were suffering intense (M2) and moderate pain (M4) are positioned at the left side of the figure. On the opposite side are the ellipses corresponding to the moments pigs were probably not suffering pain (M1 and M3). All items on the scale were influenced by pain (M2 and M4) since their vectors are positioned in the direction of these ellipses.
Table 9.
Principal component analysis showing load, eigenvalue, and variance after the analysis of the main components with the Kaiser criterion of the UPAPS.
Table 10.
Item-total correlation between each item score and total score for the UPAPS.
Table 11.
Internal consistency of the UPAPS.
Table 12.
Medians (range) of the total scores (0–18) of the UPAPS assessed at the 2nd phase of video analysis.
Table 13.
Specificity (in M1) and sensitivity (in M2) of each item of the UPAPS assessed according to the 2nd phase of the gold standard video analysis.
Fig 3.
Frequency of the presence of scores of each item of the UPAPS.
Legend: posture (top left), interaction and interest in the surroundings (top right), activity (bottom left) and appetite (bottom right).
Fig 4.
Frequency of the presence of scores of each item of the UPAPS.
Legend: sum of the scores (top left) and individual scores (bottom left) of attention to the affected area and sum of the scores (top right) and individual scores (bottom right) of miscellaneous behaviours.
Fig 5.
ROC curve and AUC (left) and two-graphic ROC curve with the diagnostic uncertainty zone for the UPAPS (right).
Legend: UPAPS—UNESP-Botucatu pig composite acute pain scale. Receiver Operating Characteristic (ROC) curve with 95% confidence interval (CI) calculated from 1000 replications and area under the curve (AUC) (A—left). Two-graphic ROC curve, CI of the 1000 replications and of sensitivity and specificity > 0.90 applied to estimate the diagnostic uncertainty zone of the cut-off point using all moments of pain assessment scored by all observers in the 2nd evaluation phase, according to the Youden index for the UPAPS (B—right).
Table 14.
Specificity, sensitivity, and Youden index of each observer for each scale score of the UPAPS (A); 95% confidence intervals of 1000 replications and of sensitivity and specificity > 0.90 applied to estimate the diagnostic uncertainty zone of the cut-off point of each evaluator, according to the Youden index (B).
Table 15.
Scores, specificity, sensitivity, and Youden index corresponding to rescue analgesia indication of the UPAPS and unidimensional scales.
Table 16.
Percentage of pigs present in the diagnostic uncertainty zone according to the Youden index of the UPAPS (scores 4 or 5).
Fig 6.
Dendogram created by the non-hierarchical cluster analysis based on the total score of the UPAPS.
Legend: UPAPS—UNESP-Botucatu pig composite acute pain scale. The scores were graded into 4 groups: no pain (0–2), mild (3–6), moderate (7–9) and intense pain (10–17).
Fig 7.
Box plot of the scores related to pain intensity of the UPAPS.
Legend: UPAPS—UNESP-Botucatu pig composite acute pain scale. Data were grouped at the time of most intense pain (M2). According to the median, minimum and maximum scores obtained by the non-hierarchical cluster analysis, the scores were graded into 4 groups: no pain (0–2), mild (3–6), moderate (7–9) and intense pain (10–17). Different letters indicate statistical difference according to the Kruskal-Wallis test, with a> b> c > d.