Preliminary appraisal of the reliability and validity of the Colorado State University Feline Acute Pain Scale

Hilary Shipley, Alonso Guedes, Lynelle Graham, Elizabeth Goudie-DeAngelis, Erin Wendt-Hornickle

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Objectives: The objective of this study was to determine the inter-rater reliability and convergent validity of the Colorado State University Feline Acute Pain Scale (CSU-FAPS) in a preliminary appraisal of its performance in a clinical teaching setting. Methods: Sixty-eight female cats were assessed for pain after ovariohysterectomy. A cohort of 21 cats was examined independently by four raters (two board-certified anesthesiologists and two anesthesia residents) with the CSU-FAPS, and intra-class correlation coefficient (ICC) was used to determine inter-rater reliability. Weighted Cohen’s kappa was used to determine inter-rater reliability centered on the ‘need to reassess analgesic plan’ (dichotomous scale). A separate cohort of 47 cats was evaluated independently by two raters (one board-certified anesthesiologist and one veterinary small animal rotating intern) using the CSU-FAPS and the Glasgow Composite Measure Pain Scale (CMPS-Feline), and Spearman rank-order correlation was determined to assess convergent validity. Reliability was interpreted using Altman’s classification as very good, good, moderate, fair and poor. Validity was considered adequate if correlation coefficients were between 0.4 and 0.8. Results: The ICC was 0.61 for anesthesiologists and 0.67 for residents, indicating good reliability. Weighted Cohen’s kappa was 0.79 for anesthesiologists and 0.44 for residents, indicating moderate to good reliability. The Spearman rank correlation indicated a statistically significant (P = 0.0003) positive correlation (0.31; 95% confidence interval 0.14–0.46) between the CSU-FAPS and the CMPS-Feline. Conclusions and relevance: The CSU-FAPS showed moderate-to-good inter-rater reliability when used by veterinarians to assess pain level or need to reassess analgesic plan after ovariohysterectomy in cats. The validity fell short of current guidelines for correlation coefficients and further refinement and testing are warranted to improve its performance.

Original languageEnglish (US)
Pages (from-to)335-339
Number of pages5
JournalJournal of Feline Medicine and Surgery
Issue number4
StatePublished - Apr 1 2019

Bibliographical note

Funding Information:
The authors thank Dr Aaron Rendahl, Dr Hanah Suh, Dr Wanda Gordon-Evans, Minji Cho, Eileen Kuhlmann and Sally Lightner from the College of Veterinary Medicine, University of Minnesota, for assisting with the statistical analysis and for technical assistance, as well as Peter W Hellyer from the College of Veterinary Medicine and Biomedical Sciences, Colorado State University, for giving permission to test the CSU-FAPS in this study. The authors received no financial support for the research, authorship, and/or publication of this article.

Publisher Copyright:
© ISFM and AAFP 2018.


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