BACKGROUND Crossmatching is used to prevent life-threatening transfusion reactions in horses. Laboratory methods are laborious and technically challenging, which is impractical during emergencies. HYPOTHESIS/OBJECTIVES Evaluate agreement between a stall-side crossmatch kit (KIT) and a laboratory method (LAB) in horses with known and unknown blood types. ANIMALS Twenty-four blood-typed and alloantibody-screened healthy adult horses (Aim 1) and 156 adult horses of unknown blood type (Aim 2). METHODS Prospective, blinded study. Expected positive (n = 35) and negative (n = 36) crossmatches among 24 antibody and blood-typed horses were used to determine sensitivity and specificity of KIT and LAB against the reference method. Agreement in 156 untyped horses was evaluated by reciprocal crossmatch (n = 156). RESULTS Sensitivity (95% confidence interval [CI]) for LAB and KIT compared with expected reactions was 77.1% (59.9%-90.0%) and 91.4% (77.0%-98.2%), and specificity 77.8% (60.9%-89.9%) and 73.5% (55.6%-87.1%), respectively. The KIT was 100% sensitive for Aa reactions; LAB was 100% sensitive for Qab; and both were 100% sensitive for Ca. Cohen's κ agreement for LAB and KIT with expected positive and negative reactions (n = 71) was moderate (0.55 [0.36-0.74]) and substantial (0.65 [0.47-0.82]), respectively. Agreement was fair comparing LAB with KIT in Aim 1 (0.30 [0.08-0.52]) and in untyped horses in Aim 2 (0.26 [0.11-0.41]). CONCLUSIONS AND CLINICAL IMPORTANCE Agreement between KIT and LAB with expected reactions was blood type dependent. Performance of both methods depends on blood type prevalence.

中文翻译：

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马匹的失速侧和实验室主要交叉比赛测试与参考标准方法的协议。

背景技术交叉匹配用于防止马中危及生命的输血反应。实验室方法费力且在技术上具有挑战性，这在紧急情况下不切实际。假设/目标评估血型已知和未知的马匹的失速侧交叉匹配试剂盒（KIT）和实验室方法（LAB）之间的一致性。动物24只经血型和同种抗体筛选的健康成年马（目标1）和156名未知血型的成年马（目标2）。方法前瞻性，盲法研究。使用24种抗体和血型马之间预期的阳性（n = 35）和阴性（n = 36）交叉匹配来确定KIT和LAB对参考方法的敏感性和特异性。通过相互交叉匹配（n = 156）评估了156匹无类型马的一致性。结果LAB和KIT的敏感性（95％置信区间[CI]）与预期反应相比为77.1％（59.9％-90.0％）和91.4％（77.0％-98.2％），特异性为77.8％（60.9％-89.9％） ）和73.5％（55.6％-87.1％）。KIT对Aa反应具有100％的敏感性；LAB对Qab敏感度为100％；而且两者对Ca的敏感性均为100％。Cohen对LAB和KIT具有预期的阳性和阴性反应（n = 71）的κ一致性分别为中等（0.55 [0.36-0.74]）和充分（0.65 [0.47-0.82]）。在目标1（0.30 [0.08-0.52]）和目标2中无类型马匹（0.26 [0.11-0.41]）中比较LAB和KIT的协议是公平的。结论和临床意义试剂盒和LAB的预期反应一致取决于血型。两种方法的性能取决于血型的患病率。