In practice, veterinary surgeons frequently rely on lung auscultation as a confirmation test for pneumonia. To what extent diagnostic accuracy of lung auscultation varies between different practitioners is currently unknown. In this diagnostic test study, 49 Dutch veterinarians each auscultated between 8 and 10 calves, and communicated whether they would decide to treat the animal with antimicrobials or not. They were not allowed to perform any other aspect of the clinical examination. Their decisions were compared with lung ultrasonography findings. The average sensitivity and specificity of lung auscultation were 0.63 (sd=0.2; range=0.2–1.0) and 0.46 (sd=0.3; range=0.0–1.0), respectively. Of the participants, 8.2 per cent were 100 per cent sensitive, 16.3 per cent were 100 per cent specific, and only 4.0 per cent were perfect. The Krippendorff’s alpha was 0.18 (95 per cent confidence interval: −0.01 to 0.38), signifying poor reliability between multiple raters. Regardless of the poor diagnostic accuracy in this study, especially the large variation in a confirmation test between different practitioners could potentially cause professional damage as well as misuse of antimicrobials. This study could be seen as a gentle stimulus to regularly evaluate one’s diagnostic skills. Both complementary training and the use of more accurate techniques with less inter-rater variation could improve the situation.
- antimicrobial use
- confirmation test
- lung ultrasonography
- bovine respiratory disease
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Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests The present study was done within the framework of a Zoetis BRD master class on lung ultrasonography in calves. The authors declare that the present results have not been influenced by this pharmaceutical company.
Ethics approval The study protocol was approved by the ethical committee of the Faculty of Veterinary Medicine, Ghent University.
Provenance and peer review Not commissioned; externally peer reviewed.
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