Inter-rater agreement of a newborn calf lung ultrasound scoring system.

Newborn calf LUS scoring system shows excellent inter-observer agreement and reliability.

This study evaluated the inter-rater reliability of a newly developed lung ultrasound (LUS) scoring system for newborn calves, adapted from human neonatology protocols. Fourteen veterinarians with LUS expertise from four countries independently scored 50 thoracic ultrasound items (25 images and 25 videos) from calves within 48 hours of birth using a 0-4 scale assessing lung aeration and consolidation patterns. After brief standardized instruction, raters demonstrated excellent inter-observer agreement with raw percentage agreement of 95.7%, Gwet's AC2 of 0.845, Krippendorff's alpha of 0.839, and weighted Fleiss' kappa of 0.849. Media quality and diagnostic confidence ratings were high (median 4/5). Agreement improved slightly when restricted to high-confidence assessments (scores 4-5). The results demonstrate that this adapted LUS scoring system provides reliable, reproducible assessment of pulmonary pathology in neonatal calves, supporting its potential for future clinical validation and monitoring of lung changes during the critical perinatal period.

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