Bristol Rabbit Pain Scale (BRPS): Clinical utility, validity and reliability

Livia Benato*, Jo C Murrell, Nicola J Rooney

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

13 Citations (Scopus)
190 Downloads (Pure)

Abstract

Background
The Bristol Rabbit Pain Scale (BRPS) was developed using a combination of methods, focus groups and behavioural observation, that led to a composite pain scale of six categories (Demeanour, Locomotion, Posture, Ears, Eyes and Grooming) with four intensities of pain (0, 1, 2, and 3), and a total score of 0–18. The aim of this study was to assess the clinical utility, validity and reliability of the BRPS.

Materials and methods
The clinical utility of the BRPS was tested using a questionnaire composed of ten questions each on a five-point Likert scale ranging from one (strongly disagree) to five (strongly agree). The respondents, (veterinary surgeons and veterinary nurses), were asked to assess up to four rabbits in acute pain, using the novel pain. They then completed the questionnaire which asked whether the BRPS was easy and quick to use and whether it provided information that was clinically useful. The questionnaire was tested for internal reliability using the Cronbach’s alpha reliability coefficient. The construct validity (how well the tool measures the concept it was designed for) was measured by observers blindly rating 20 rabbits pre- and post-surgery whilst the criterion validity (the degree to which the tool correlates with a gold standard) was assessed by correlating BRPS scores with scores using a numerical rating scale (NRS) with a total score of 0–10. Inter-rater reliability was tested by quantifying the agreement in the pain scores given by nine participants when assessing the same 40 video clips. The intra-rater reliability was measured by testing how consistent the participants were when rating the same clips one month later.

Results
The median score of the ten questions of the clinical utility test was 4 (range 2–5). The Cronbach’s alpha reliability coefficient of the clinical utility test was good (α = 0.811) demonstrating good internal consistency. The median (range) pain score of the BRPS and the NRS were 3 (0–14) and 0 (0–8) before surgery and 12 (1–18) and 7 (0–10) after surgery respectively. The BRPS demonstrated high construct validity (Z = -11.452; p < 0.001) and there was a strong correlation between the BRPS and the NRS (Rho = 0.851; p < 0.001) indicating high criterion validity. The inter-rater and the intra-rater agreements were α = 0.863 and α = 0.861 respectively, which is considered good.

Conclusions
This study showed that the BRPS is a suitable tool for quantifying pain in rabbits in a clinically useful, valid and reliable way.
Original languageEnglish
Article number341
Number of pages9
JournalBMC Veterinary Research
Volume18
Issue number1
DOIs
Publication statusPublished - 9 Sept 2022

Bibliographical note

Funding Information:
The authors would like to thank The Alumni Association of the University of Bristol who supported this work, Professor Toby Knowles for statistical advice and all the respondents and participants for their time and feedback.

Funding Information:
This study was supported by the Alumni Association of the University of Bristol. The Alumni Association of the University of Bristol also provided support via salary to LB. Highcroft Veterinary Referrals provided support via salary to JM, but they did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2022, The Author(s).

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