Assessment of the Diagnostic Sensitivity and Specificity of Pain biomarkers in Cattle Using Receiver Operating Characteristic Curves

Citation

Assessment of the Diagnostic Sensitivity and
Specificity of Pain Biomarkers in Cattle Using
Receiver Operating Characteristic Curves.
Miriam S. Martin1, Michael Kleinhenz1,
Karen Schwartzkopf-Genswein2, Johann
Coetzee1, 1Kansas State University College of
Veterinary Medicine, 2Agriculture and Agri-Food
Canada, Lethbridge Research Centre
doi:10.1093/jas/skaa054.012

Plain language summary

Biomarkers are commonly used to assess pain and analgesic drug efficacy in livestock. However, the diagnostic sensitivity and specificity of these biomarkers for different pain conditions over time have not been
described. Receiver Operating Characteristic curves are graphical plots that illustrate the diagnostic ability of a test as its discrimination threshold is varied. The objective of this analysis was to use area
under the curve values derived from the receiver operating characteristic curves analysis to assess the predictive value of pain biomarkers at specific time points. The biomarkers included in the
analysis were Blood Cortisol, Salivary Cortisol, Hair Cortisol, Infrared Thermography, Mechanical Nociceptive threshold, Substance P, and outcomes from a pressure/force measurement system and visual
analog scale. Biomarker outcomes were collected from 6 pain studies involving pain associated with castration, dehorning, lameness, and surgery were included in the analysis. Results comparing analgesia verses pain yielded good diagnostic accuracy for Blood Cortisol; Infrared thermography; and Mechanical Nociceptive Threshold. These results indicate that Receiver Operating Characteristic analysis can be a useful indicator of the predictive value of pain biomarkers and certain time points seem to yield good diagnostic accuracy while many do not.

Abstract

Biomarkers are commonly used to assess pain and analgesic drug efficacy in livestock. However, the diagnostic sensitivity and specificity of these biomarkers for different pain conditions over time have not been
described. Receiver operating characteristic (ROC) curves are graphical plots that illustrate the diagnostic ability of a test as its discrimination threshold is varied. The objective of this analysis was to use area
under the curve (AUC) values derived from ROC analysis to assess the predictive value of pain biomarkers
at specific timepoints. The biomarkers included in the analysis were blood cortisol, salivary cortisol, hair cortisol, infrared thermography (IRT), mechanical nociceptive threshold (MNT), substance P, and outcomes
from a pressure/force measurement system and visual analog scale. A total sample size of 7,992 biomarker
outcomes were collected from 6 pain studies involving pain associated with castration, dehorning, lameness,
and surgery were included in the analysis. Each study consisted of three treatments; pain, no pain, and analgesia. All statistics were performed using statistical software (JMP Pro 14.0, SAS Institute, Inc., Cary,
NC). Results comparing analgesia verses pain yielded good diagnostic accuracy (AUC > 0.7; 95% CI: 0.40
to 0.99) for blood cortisol (timepoints 1.5, 2, and 6 hours); IRT (timepoints 6, 8, 12, and 72 hours); and
MNT (timepoints 6, 25, and 49 hours). These results indicate that ROC analysis can be a useful indicator
of the predictive value of pain biomarkers and certain timepoints seem to yield good diagnostic accuracy
while many do not.

Publication date

2020-11-30