Development and psychometric testing of an instrument designed to measure chronic pain in dogs with osteoarthritis

Abstract

Objective-To develop and psychometrically test an owner self-administered questionnaire designed to assess severity and impact of chronic pain in dogs with osteoarthritis.Sample Population-70 owners of dogs with osteoarthritis and 50 owners of clinically normal dogs.Procedures-Standard methods for the stepwise development and testing of instruments designed to assess subjective states were used. Items were generated through focus groups and an expert panel. Items were tested for readability and ambiguity, and poorly performing items were removed. The reduced set of items was subjected to factor analysis, reliability testing, and validity testing.Results-Severity of pain and interference with function were 2 factors identified and named on the basis of the items contained in them. Cronbach's α was 0.93 and 0.89, respectively, suggesting that the items in each factor could be assessed as a group to compute factor scores (ie, severity score and interference score). The test-retest analysis revealed κ values of 0.75 for the severity score and 0.81 for the interference score. Scores correlated moderately well (r = 0.51 and 0.50, respectively) with the overall quality-of-life (QOL) question, such that as severity and interference scores increased, QOL decreased. Clinically normal dogs had significantly lower severity and interference scores than dogs with osteoarthritis. Conclusions and Clinical Relevance-A psychometrically sound instrument was developed.Responsiveness testing must be conducted to determine whether the questionnaire will be useful in reliably obtaining quantifiable assessments from owners regarding the severity and impact of chronic pain and its treatment on dogs with osteoarthritis.It is crucial to have quantitative measures of chronic pain that are valid and reliable in clinical patients to enable development and testing of interventions (such as drugs or surgical procedures) designed to reduce such pain. In the past, studies designed to test the efficacy of interventions intended to decrease chronic pain in dogs with osteoarthritis have relied heavily on a veterinarian's assessment of lameness supported by values generated through gait analysis by use of a force plate. When collected properly, data on gait analysis offer an objective measure that can be reliably monitored over time; however, it can be extremely time consuming, requires specialized equipment, and relies on relatively strict inclusion criteria. In addition, these measures only evaluate an animal at 1 specific point in NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript time, and weight bearing on an affected limb is only 1 part of the much larger picture of chronic pain in dogs with osteoarthritis. [1][2][3][4][5] When an owner brings a dog to a veterinarian with a concern that the dog has signs of a chronic painful condition, they report a number of behaviors that they attribute to the painful condition (eg, no longer climbs stairs or jumps onto the bed). In monitoring the progression of the dog's cond...

Development of a scale to evaluate mobility in dogs

“…(HOLTON et al, 2001;MILLIS, 2004;WISEMAN-ORR et al, 2004;BROWN et al 2007;HESBACH, 2007;QUINN et al, 2007;REID, 2007;HIELM-BJORKMAN et al, 2011;LAVAN, 2013).…”

Diagnosis of Pain in Small Companion Animals

“…Worthy of mention among the scales already available for scoring chronic pain are the "Canine Brief Pain Inventory" (CBPI) (Brown et al, 2007;2008), the "Helsinki Chronic Pain Index" (HCPI) (HielmBjörkman et al, 2009) and the "Feline Musculoskeletal Pain Index" (FMPI) (Benito et al, 2013). The CBPI is a two-part instrument.…”

The Challenges of Assessing Osteoarthritis and Postoperative Pain in Dogs

“…This owner-completed questionnaire developed to measure OA pain, has also been used to measure cancer pain in dogs (18,52,53). The CBPI questionnaire asks owners to: (1) rate the dog's pain at its worst, its least, on average, and at the current moment and (2) rate the dog's activity level and quality of life.…”

“…For example, the content validity, reliability, and responsiveness of the CBPI and HCPI have been evaluated (18,52,59) and the content and criterion validity, responsiveness, and reliability of the Liverpool Osteoarthritis questionnaire have been studied (59). Additional work is needed to continue validation of the PATs used in veterinary medicine to determine their reliability and responsiveness when used in other studies, by individuals not familiar with the development of the tool, and when used in various languages to improve their comprehensive use.…”