Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-22T18:52:47.389Z Has data issue: false hasContentIssue false

Theory of medical scoring systems and a practical method to evaluate Asian elephant (Elephas maximus) foot health in European zoos

Published online by Cambridge University Press:  01 January 2023

N Ertl*
Affiliation:
Hochstraße 14, 95189 Köditz, Germany Clinic for Zoo Animals, Exotic Pets and Wildlife, Winterthurerstrasse 260, CH-8057, Zurich, Switzerland
P Wendler*
Affiliation:
Clinic for Zoo Animals, Exotic Pets and Wildlife, Winterthurerstrasse 260, CH-8057, Zurich, Switzerland
E Sós
Affiliation:
Budapest Zoo & Botanical Garden, Budapest, Állatkerti Krt 6-12, 1146, Hungary
M Flügger
Affiliation:
Tierpark Hagenbeck, Lokstedter Grenzstraße 2, 22527 Hamburg, Germany
F Schneeweis
Affiliation:
Technische Universität Dresden, Fakultät Mathematik, 01062 Dresden, Germany
C Schiffmann
Affiliation:
Clinic for Zoo Animals, Exotic Pets and Wildlife, Winterthurerstrasse 260, CH-8057, Zurich, Switzerland
J-M Hatt
Affiliation:
Clinic for Zoo Animals, Exotic Pets and Wildlife, Winterthurerstrasse 260, CH-8057, Zurich, Switzerland
M Clauss
Affiliation:
Clinic for Zoo Animals, Exotic Pets and Wildlife, Winterthurerstrasse 260, CH-8057, Zurich, Switzerland
*
* Contacts for correspondence: [email protected]/[email protected]
* Contacts for correspondence: [email protected]/[email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Several established models in human and veterinary medicine exist to evaluate an individual health or disease status. Many of these seem unsuitable for further epidemiological research aimed at discovering underlying influential factors. As a case example for score development and choice, the present study analyses different approaches to scoring the foot health of Asian elephants (Elephas maximus) living in European facilities. Sum scores with varying degree of detail, and without or with a weighting method, were compared using descriptive statistics, ie kurtosis, skewness, Shannon entropy, total redundancy, their maximum and their actual ranges. With increasing score complexity, a higher level of differentiation was reached. In parallel, the distribution of score frequencies in the population shifted systematically: with the least complex scoring model the pattern indicated a severely unhealthy population with an opposite skew to a hypothetically healthy population, whereas the most complex scoring model indicated a mildly affected population with a skew corresponding to that expected for a healthy population. We propose the latter, in the form of the Particularised Severity Score (ParSev), which accounts for every nail and pad individually and weights the sub-scores by squaring, as the most relevant score for further investigations, either in assessing changes within an elephant population over time, or correlating foot health in epidemiological studies to potentially influencing factors. Our results emphasise the relevance of choosing appropriate scoring models for welfare-associated evaluations, due to implications for the applicability as well as the perceived welfare status of the test population.

Type
Research Article
Copyright
© 2020 Universities Federation for Animal Welfare

References

Apgar, VV and James, LS 1962 Further observations on the newborn scoring system. American Journal of Diseases of Children 104: 419428. https://doi.org/10.1001/archpe-di.1962.02080030421015Google ScholarPubMed
Austin, PC, Lee, DS, D’Agostino, RB and Fine, JP 2016 Developing points-based risk-scoring systems in the presence of competing risks. Statistics in Medicine 35: 40564072. https://doi.org/10.1002/sim.6994CrossRefGoogle ScholarPubMed
Avila, ML, Stinson, J, Kiss, A, Brandao, LR, Uleryk, E and Feldman, BM 2015 A critical review of scoring options for clin-ical measurement tools. BMC Research Notes 8: 612. Ahttps://doi.org/10.1186/s13104-015-1561-6CrossRefGoogle Scholar
Baker, SP, O’Neill, B, Haddon, W Jr and Long, WB 1974 The injury severity score: a method for describing patients with multi-ple injuries and evaluating emergency care. Journal of Trauma and Acute Care Surgery 14: 187196. https://doi.org/10.1097/00005373-197403000-00001CrossRefGoogle Scholar
Benson, M, Koenig, KL and Schultz, CH 1996 Disaster triage: START, then SAVE—a new method of dynamic triage for victims of a catastrophic earthquake. Prehospital and Disaster Medicine 11:117124. https://doi.org/10.1017/S1049023X0004276XCrossRefGoogle ScholarPubMed
Bollen, KA and Bauldry, S 2011 Three Cs in measurement models: causal indicators, composite indicators and covariates. Psychological Methods 16: 265284. https://doi.org/10.1037/a0024448CrossRefGoogle ScholarPubMed
Champion, HR, Sacco, WJ, Lepper, RL, Atzinger, EM, Copes, WS and Prall, R 1980 An anatomic index of injury sever-ity. The Journal of Trauma: Injury, Infection and Critical Care 20: 197202. https://doi.org/10.1097/00005373-198003000-00001CrossRefGoogle Scholar
Clauss, M and Hummel, J 2005 The digestive performance of mammalian herbivores: why big may not be that much better. Mammal Review 35: 174187. https://doi.org/10.1111/j.1365-2907.2005.00062.xCrossRefGoogle Scholar
Csuti, B, Sargent, EL and Bechert, US 2001 The Elephant's Foot: Prevention and Care of Foot Conditions in Captive Asian and African elephants. Iowa State University Press: Ames, IA, USA. https://doi.org/10.1002/9780470292150Google Scholar
Edmonson, A, Lean, I, Weaver, L, Farver, T and Webster, G 1989 A body condition scoring chart for Holstein dairy cows. Journal of Dairy Science 72: 6878. https://doi.org/10.3168/jds.S0022-0302(89)79081-0CrossRefGoogle Scholar
Ekstrand, C, Algers, B and Svedberg, J 1994 Rearing conditions and foot-pad dermatitis in Swedish broiler chickens. Preventive Veterinary Medicine 31: 167174. https://doi.org/10.1016/S0167-5877(96)01145-2CrossRefGoogle Scholar
Fowler, M 2006 Foot disorders. In: Mikota, SK and Fowler, M (eds) Biology, Medicine, and Surgery of Elephants, Volume One pp 271290. Blackwell Publishing Professional: Ames, IA, USA. https://doi.org/10.1002/9780470344484.ch20CrossRefGoogle Scholar
Harris, M, Sherwin, C and Harris, S 2008 The welfare, housing and husbandry of elephants in UK zoos p 127. University of Bristol: Bristol, UKGoogle Scholar
Haspeslagh, M, Stevens, JMG, De Groot, E, Dewulf, J, Kalmar, ID and Moons, CPH 2013 A survey of foot problems, stereotypic behaviour and floor type in Asian elephants (Elephas maximus) in European zoos. Animal Welfare 22: 437443. https://doi.org/10.7120/09627286.22.4.437CrossRefGoogle Scholar
Howell, RD, Breivik, E and Wilcox, JB 2007 Reconsidering formative measurement. Psychological Methods 12: 205218. https://doi.org/10.1037/1082-989X.12.2.205CrossRefGoogle ScholarPubMed
IBM 1968 SPSS, 23rd Edition. IBM: London, UKGoogle Scholar
Ihaka, R and Gentleman, R 1993 R Project, Edition 3.4.1. The R Foundation for Statistical Computing: Vienna, AustriaGoogle Scholar
Jones, C 1979 Glasgow Coma Scale. The American Journal of Nursing 79: 15511553. https://doi.org/10.2307/3424679Google ScholarPubMed
Kim, H 2013 Statistical notes for clinical researchers: assessing normal distribution (2) using skewness and kurtosis. Restorative Dentistry & Endodontics 38: 5254. https://doi.org/10.5395/rde.2013.38.1.52CrossRefGoogle ScholarPubMed
Knaus, WA, Draper, EA, Wagner, DP and Zimmerman, JE 1985 APACHE II: A severity of disease classification system. Critical Care Medicine 13: 818829. https://doi.org/10.1097/00003246-198510000-00009CrossRefGoogle ScholarPubMed
Knaus, WA, Wagner, DP, Draper, EA, Zimmerman, JE, Bergner, M, Bastos, PG, Sirio, CA, Murphy, DJ, Lotring, T, Damiano, A and Harrell, FE 1991 The APACHE III prognostic system: Risk prediction of hospital mortality for critically ill hospi-talized adults. Chest 100: 16191636. https://doi.org/10.1378/chest.100.6.1619CrossRefGoogle Scholar
Le Gall, J-R, Lemeshow, S and Saulnier, F 1993 A new simplified acute physiology score (SAPS II) based on a European/North American multicenter study. The Journal of the American Medical Association 270: 29572963. https://doi.org/10.1001/jama.270.24.2957CrossRefGoogle ScholarPubMed
Lewis, KD, Shepherdson, DJ, Owens, TM and Keele, M 2010 A survey of elephant husbandry and foot health in North American zoos. Zoo Biology 29: 221236. https://doi.org/10.1002/zoo.20291Google ScholarPubMed
Miller, MA, Hogan, JN and Meehan, CL 2016 Housing and demographic risk factors impacting foot and musculoskeletal health in African elephants (Loxodonta africana) and Asian ele-phants (Elephas maximus) in North American zoos. PLoS One 11: e0155223. https://doi.org/10.1371/journal.pone.0155223CrossRefGoogle Scholar
Moler, C 1984 Matlab, Matlab, Mathworks, University New Mexico: USAGoogle Scholar
Nielsen, AM, Nielsen, SS, King, CE and Bertelsen, MF 2010 Classification and prevalence of foot lesions in captive flamingos (Phoenicopteridae). Journal of Zoo and Wildlife Medicine 41: 4449. https://doi.org/10.1638/2009-0095.1CrossRefGoogle ScholarPubMed
Pettilä, V, Pettila, M, Sarna, S, Voutilainen, P and Takkunen, O 2002 Comparison of multiple organ dysfunction scores in the prediction of hospital mortality in the critically ill. Critical Care Medicine 30: 17051711. https://doi.org/10.1097/00003246-200208000-00005CrossRefGoogle ScholarPubMed
Ramanathan, A and Mallapur, A 2008 A visual health assess-ment of captive Asian elephants (Elephas maximus) housed in India. Journal of Zoo and Wildlife Medicine 39: 148154. https://doi.org/10.1638/2007-0008R1.1CrossRefGoogle Scholar
Sarma, KK, Thomas, S, Gogoi, D, Sarma, M and Sarma, DK 2012 Foot diseases in captive elephants. Intas Polivet 13: 221227Google Scholar
Shannon, CE, Weaver, W and Burks, AW 1949 The Mathematical Theory of Communication. University of Illinois Press: Illinois, IL, USAGoogle Scholar
Vincent, J-L and Moreno, R 2010 Clinical review: scoring sys-tems in the critically ill. Critical Care 14: 207. https://doi.org/10.1186/cc8204CrossRefGoogle Scholar
Wendler, P, Ertl, N, Flügger, M, Sós, E, Schiffmann, C, Clauss, M and Hatt, JM 2019 Foot health of Asian elephants (Elephas maximus) in European zoos. Journal of Zoo and Wildlife Medicine 50(3): 513527. https://doi.org/10.1638/2018-0228CrossRefGoogle ScholarPubMed
Wyss, F, Wenker, C, Hoby, S, Gardelli, B, Studer-Thiersch, A, von Houwald, F, Schumacher, V, Clauss, M, Doherr, MG, Hafeli, W, Furrer, S, Bechet, A and Robert, N 2013 Factors influencing the onset and progression of pododermatitis in captive flamingos (Phoenicopteridae). Schweizer Archiv für Tierheilkunde 155: 497503. https://doi.org/10.1024/0036-7281/a000499CrossRefGoogle ScholarPubMed
Zimmerman, JE, Wagner, DP, Draper, EA, Wright, L, Alzola, C and Knaus, WA 1998 Evaluation of acute physiology and chronic health evaluation III predictions of hospital mortality in an independent database. Critical Care Medicine 26: 13171326. https://doi.org/10.1097/00003246-199808000-00012CrossRefGoogle ScholarPubMed