Evidence‐based evaluation of owner‐reported outcome measures for canine orthopedic care – a COSMIN evaluation of 6 instruments

Abstract

Objective To systematically review the currently available validated owner‐reported outcome measures (OROMs) for assessing pain and function in dogs with osteoarthritis and other joint diseases. Study design Systematic review. Methods A systematic literature search of PubMed and Web of Science was performed in December, 2019, using search terms relevant to OROMs for pain and function in dogs with osteoarthritis and other joint diseases. The measurement properties of the resulting outcome instruments and validation studies were evaluated with the Consensus‐Based Standards for the Selection of Health Measurement Instruments (COSMIN). Results Seventeen publications describing the validation of 6 OROMs were selected and evaluated with the COSMIN. The Canine Brief Pain Inventory (CBPI), Canine Orthopedic Index (COI), and Liverpool Osteoarthritis in Dogs (LOAD) provided evidence of sufficient content validity. Internal consistency, reliability, construct validity, and responsiveness were the most frequently validated other properties. Both CBPI and COI had sufficient internal consistency; LOAD, being formative in construct, need not be assessed for internal consistency. No instruments provided information on measurement errors. Conclusion The CBPI, COI, and LOAD can be recommended for use in dogs with osteoarthritis. Further evidence is necessary to increase the interpretability of these instruments or expand their application into other canine orthopedic conditions. Further evidence is also needed before the other 3 instruments can be recommended. Clinical significance This systematic evaluation of 6 OROMs provides clinicians and researchers with a tool that facilitates and improves evidence‐based selection of outcome measures for evaluating canine osteoarthritis and other joint disease treatments.

Minimal clinically-important differences for the ‘Liverpool Osteoarthritis in Dogs’ (LOAD) and the ‘Canine Orthopedic Index’ (COI) client-reported outcomes measures

“…In veterinary medicine, the client can be used as a proxy to communicate their interpretation of their animal’s health status [ 6 , 7 , 17 ]. Client-reported outcomes measures have also been called ‘owner-reported outcomes measures’ (OROMs) [ 15 ] or ‘clinical metrology instruments’ [ 8 , 14 ]. Several CROMs have been developed for canine joint disease and some of these have been through validation processes.…”

“…A COSMIN-based systematic review of CROMs in canine joint disease was recently published [ 15 ]. Seventeen publications describing the validation of 6 CROMs were selected and evaluated with the COSMIN.…”

Owner‐reported outcome measures in veterinary care for companion animal orthopedic patients: An international online survey of veterinarians' expectations and practices

“…A few diseasespecific OROMs were found to be more well-known and more frequently applied than others, possibly because they were the most featured OROMs in the current literature 7,9,20 or there have been reports on their validity, reliability, and responsiveness. 7 The low percentage of respondents applying OROMs in routine clinical practice supported the anecdotal observation that OROMs had not been routinely applied in the everyday practice of veterinary medicine. 2 In contrast, a routine collection of patient-reported outcome measures (PROMs), the equivalent of OROMs in human medicine, has been implemented in several healthcare systems to improve the quality of care from the patients' perspective.…”

“…This is the first international survey to report veterinarians' familiarity with, current application of, and perceptions of applying OROMs in routine clinical practice for companion animal orthopedic patients. A few disease‐specific OROMs were found to be more well‐known and more frequently applied than others, possibly because they were the most featured OROMs in the current literature 7,9,20 or there have been reports on their validity, reliability, and responsiveness 7 …”

“…Two types of applications of OROMs were distinguished in this survey: the application of OROMs for research purposes referred to applying OROMs as part of veterinary clinical studies (including any interventional or observational studies); the application in routine clinical practice referred to applying OROMs not for any research purposes but as part of everyday veterinary work or standard veterinary care offered to patients who were not subjects in any kind of veterinary clinical studies. Ten disease‐specific or generic OROMs that have been featured in current literature in companion animal orthopedics 7–9 were listed in the questionnaire. Disease‐specific OROMs included Liverpool Osteoarthritis in Dogs (LOAD), 10 Canine Brief Pain Inventory (CBPI), 11 Helsinki Chronic Pain Index (HCPI), 12 Canine Orthopedic Index (COI), 13 Finnish Canine Stifle Index (FCSI), 14 and Bologna Healing Stifle Injury Index (BHSII) 15 .…”