ORIGINAL RESEARCH article
Front. Vet. Sci.
Sec. Veterinary Surgery
Volume 12 - 2025 | doi: 10.3389/fvets.2025.1577046
Inter-and intra-rater agreement among novices and comparison to an experienced consensus using the Gächter scale for evaluation of septic joints
Provisionally accepted
Tiffany Stockman1*
Michael P Kowaleski1
Jacqueline Milton Hicks2Chanel N Berns3
William B Saunders3Robert J Mccarthy1- 1Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, United States
- 2Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts, United States
- 3Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, United States
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The purpose of this retrospective study was to determine the inter-and intra-rater agreement among novice raters, as well as agreement between novice raters and an experienced consensus using the Gächter grading scale for evaluation of severity of septic joints in dogs. Three surgical residents served as novice raters, and two American College of Veterinary Surgery (ACVS) diplomates, experienced with arthroscopic evaluation of canine joints served as the experienced consensus.Arthroscopy images were first evaluated by the experienced consensus and scored using the Gächter scale. After two supervised training sessions novices applied the scale twice to the same images, two weeks apart. Application of the Gächter grading scale was unreliable in dogs when utilized by novice raters. Both the intra-rater agreement measured among the three novice raters and inter-rater reliability comparing the three novice raters to an expert consensus showed a consistently low concurrence among the individuals when tested at two separate time intervals. Lack of skill with arthroscopy, awareness of the anatomy and potential anatomic variations, and inadequate training in the application of the Gächter grading scheme could play a large part in a novice's ability to apply the grading scale to a septic joint. Inter-rater agreement, while initially moderate, had a decreasing concurrence between the two time intervals.
Keywords: Gächter1, Septic arthritis2, septic joint3, Arthroscopy4, inter-rater agreement5, intrarater agreement6
Received: 14 Feb 2025; Accepted: 19 Jun 2025.
Copyright: © 2025 Stockman, Kowaleski, Hicks, Berns, Saunders and Mccarthy. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tiffany Stockman, Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, 01536, Massachusetts, United States
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