Delphi consensus on Thoroughbred yearling sales endoscopy in Australasia

BACKGROUND: Concerns regarding the reliability and consistency of yearling sales endoscopy in Australia and New Zealand have led to reduced industry confidence. Recent studies have clarified the relationship between yearling laryngeal function (YLF) grades and future outcomes. OBJECTIVES: To build expert consensus on the most appropriate method for grading YLF, assess the clinical relevance of each grade on future race performance and prosthetic laryngoplasty risk, and develop guidelines for pre-sale endoscopic technique. STUDY DESIGN: Modified Delphi study. METHODS: Anonymous, iterative surveys were distributed to expert veterinarians in Australia and New Zealand. Consensus was defined a priori as ≥75% agreement. Surveys included closed and open-ended questions, with qualitative and quantitative data analysed after each round. Panellists received a summary of responses before each subsequent round. Items reaching consensus were excluded from later rounds, and new items were added based on panellist feedback. RESULTS: Three survey rounds were completed, with 40 veterinarians, 39 (97.5%) and 37 (92.3%) respectively. Consensus was achieved on adopting the Havemeyer grading system, standardising pre-sale endoscopic techniques, and implementing a four-tier risk-rating system for YLF grades. Grades I and II.1 YLF were classified as low-risk; grade II.2 as low-moderate-risk; grade III.1 as moderate-risk; and ≥grade III.2 as high-risk. Descriptors were developed to guide risk categorisation based on observed YLF. MAIN LIMITATIONS: Steering committee members were involved in prior research. CONCLUSIONS: This study provides a foundation for evidence-based guidelines that enhance the transparency, consistency, and animal welfare in yearling sales endoscopy, supporting better-informed purchasing decisions.