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Inter-observer agreement of canine and feline paroxysmal event semiology and classification by veterinary neurology specialists and non-specialists

Packer, RMA, Berendt, M, Bhatti, S, Charalambous, M, Cizinauskas, S, De Risio, L, Farquhar, R, Hampel, R, Hill, M, Mandigers, PJJ , Pakozdy, A, Preston, SM, Rusbridge, Clare, Stein, VM, Taylor-Brown, F, Tipold, A and Volk, HA (2015) Inter-observer agreement of canine and feline paroxysmal event semiology and classification by veterinary neurology specialists and non-specialists BMC Veterinary Research, 11 (39).

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Advances in mobile technology mean vets are now commonly presented with videos of paroxysmal events by clients, but the consistency of the interpretation of these videos has not been investigated. The objective of this study was to investigate the level of agreement between vets (both neurology specialists and non-specialists) on the description and classification of videos depicting paroxysmal events, without knowing any results of diagnostic workup. An online questionnaire study was conducted, where participants watched 100 videos of dogs and cats exhibiting paroxysmal events and answered questions regarding: epileptic seizure presence (yes/no), seizure type, consciousness status, and the presence of motor, autonomic and neurobehavioural signs. Agreement statistics (percentage agreement and kappa) calculated for each variable, with prevalence indices calculated to aid their interpretation.


Only a fair level of agreement (κ = 0.40) was found for epileptic seizure presence. Overall agreement of seizure type was moderate (κ = 0.44), with primary generalised seizures showing the highest level of agreement (κ = 0.60), and focal the lowest (κ =0.31). Fair agreement was found for consciousness status and the presence of autonomic signs (κ = 0.21–0.40), but poor agreement for neurobehavioral signs (κ = 0.16). Agreement for motor signs ranged from poor (κ = ≤ 0.20) to moderate (κ = 0.41–0.60). Differences between specialists and non-specialists were identified.


The relatively low levels of agreement described here highlight the need for further discussions between neurology experts regarding classifying and describing epileptic seizures, and additional training of non-specialists to facilitate accurate diagnosis. There is a need for diagnostic tools (e.g. electroencephalogram) able to differentiate between epileptic and non-epileptic paroxysms.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Veterinary Medicine
Authors :
Packer, RMA
Berendt, M
Bhatti, S
Charalambous, M
Cizinauskas, S
De Risio, L
Farquhar, R
Hampel, R
Hill, M
Mandigers, PJJ
Pakozdy, A
Preston, SM
Stein, VM
Taylor-Brown, F
Tipold, A
Volk, HA
Date : 2015
DOI : 10.1186/s12917-015-0356-2
Copyright Disclaimer : © 2015 Packer et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Uncontrolled Keywords : Seizure, Epilepsy, Canine, Feline, Video, Paroxysmal event, Agreement, Kappa
Depositing User : Melanie Hughes
Date Deposited : 05 Dec 2017 11:31
Last Modified : 16 Jan 2019 19:05

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