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Table 1.

The Bovine Pain Scale consists of nine items with inclusion of three descriptive levels. Score 0 means normal behaviours (pain free), score 1 and 2 behaviours related to pain.

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Fig 1.

Timeline of video analysis for the validation of the Bovine Pain Scale.

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Table 2.

Statistical methods used for validation of the Bovine Pain Scale (BPS) in cattle.

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Table 3.

Demographics and summarized history of animals included in the Pain Group.

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Table 4.

Intra-rater reliability of the Bovine Pain Scale, unidimensional scales and indication for rescue analgesia in the perioperative period of cattle undergoing surgery (n = 25; Pain Group) and in healthy cows (n = 11; Control Group).

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Table 5.

Inter-rater reliability of the Bovine Pain Scale, unidimensional scales, and indication of rescue analgesia in the perioperative period of cattle undergoing surgery (n = 25; Pain Group) and in healthy cows (n = 11; Control Group).

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Table 6.

Loading values and eigenvalues of the Bovine Pain Scale items based on exploratory factor analysis.

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Fig 2.

Plot correlating the scores of the Bovine Pain Scale (BPS) and the Visual Analog Scale (VAS) of perioperative period of cattle undergoing surgery (n

= 25; Pain Group) and in healthy cows (n = 11; Control Group).

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Fig 2 Expand

Table 7.

Specificity and sensitivity of the Bovine Pain Scale.

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Table 7 Expand

Table 8.

Item-total correlation and internal consistency of the Bovine Pain Scale for all time-points.

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Table 9.

Responsiveness of the Bovine Pain Scale (BPS), Visual Analog Scale (VAS) and rescue analgesia, between the four perioperative time-points, showed as median (first – third quartile) (n = 25).

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Fig 3.

Box-plot of Bovine Pain Scale (BPS) total score over time-points of perioperative period of cattle undergoing surgery (n

= 25; Pain Group) and healthy cows (n = 11; Control Group) for all raters. Time-points: P1, preoperatively, immediately prior to administration of sedatives; P2, 2 to 6 hours after the end of surgery; P3, 1 hour after the administration of analgesic intervention if required; P4, 24 hours after surgery; were assessed. C1, first video and assessment of animals of the control group; C2, the second video of same animal of the control group, recorded 24-48 hours after C1. The lower and upper bounds of the box respectively represent the first and third quartile of data; the horizontal line plus space inside the box indicates the median; the black diamond indicates the average of each time-point data separately; black circles indicate outlier. Different lowercase letters indicate statistical difference over the time-points (a > b); multiple comparisons were conducted by linear mixed model with post-test corrected by Bonferroni procedure (p < 0.05).

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Fig 3 Expand

Fig 4.

ROC curve with the diagnostic uncertainty zone for the Bovine Pain Scale (BPS).

Two-graph ROC curve, CI of 1,001 replications was used to estimate the diagnostic uncertainty zone of the cut-off point of all raters, according to the Youden index [31,32]. The diagnostic uncertainty zone was 5; ≤ 4 indicates pain-free animals (true negatives) and ≥ 6 indicates animals suffering pain (true positives). The Youden index ≥ 5 represents the cut-off point for the indication of rescue analgesia.

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