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Radke et al: Evidence‐based evaluation of owner‐reported outcome measures for canine orthopedic care – a COSMIN evaluation of 6 instruments
Veterinary Surgery 2, 2022

🔍 Key Findings

  • CBPI, COI, and LOAD are recommended for assessing canine osteoarthritis based on COSMIN criteria.
  • COI scored highest in development rigor and evidence quality among evaluated OROMs.
  • Internal consistency, reliability, and responsiveness were commonly validated, though no OROMs reported measurement error.
  • LOAD was considered formative, and internal consistency assessment was deemed unnecessary.
  • CBPI and COI showed sufficient internal consistency, but CBPI’s factor structure was inconsistent across studies.
  • All 6 evaluated OROMs (CBPI, COI, LOAD, BHSII, HCPI, HVAS) were quick to complete (under 5 min).
  • Three tools—BHSII, HCPI, HVAS—need more evidence before recommendation; only CBPI, COI, and LOAD are Category A (recommended).
  • Future studies should assess interpretability, including measurement error and clinically meaningful change scores (MIC, SDC).

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← Articles

Radke et al: Evidence‐based evaluation of owner‐reported outcome measures for canine orthopedic care – a COSMIN evaluation of 6 instruments
Veterinary Surgery 2, 2022

🔍 Key Findings

  • CBPI, COI, and LOAD are recommended for assessing canine osteoarthritis based on COSMIN criteria.
  • COI scored highest in development rigor and evidence quality among evaluated OROMs.
  • Internal consistency, reliability, and responsiveness were commonly validated, though no OROMs reported measurement error.
  • LOAD was considered formative, and internal consistency assessment was deemed unnecessary.
  • CBPI and COI showed sufficient internal consistency, but CBPI’s factor structure was inconsistent across studies.
  • All 6 evaluated OROMs (CBPI, COI, LOAD, BHSII, HCPI, HVAS) were quick to complete (under 5 min).
  • Three tools—BHSII, HCPI, HVAS—need more evidence before recommendation; only CBPI, COI, and LOAD are Category A (recommended).
  • Future studies should assess interpretability, including measurement error and clinically meaningful change scores (MIC, SDC).

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Multiple Choice Questions on this study

In Radke 2022 et al., on outcome measure validation, which limitation applied to **all 6 OROMs** evaluated?

A. Lack of owner input during development
B. Low feasibility due to questionnaire length
C. No information on measurement error
D. None addressed content validity
E. Validation only in surgical populations

Answer: No information on measurement error

Explanation: No OROMs reported measurement error, limiting score interpretability.
In Radke 2022 et al., on outcome measure validation, which of the following instruments was noted to have **inconsistent factor analysis results** across validation studies?

A. Canine Orthopedic Index (COI)
B. Canine Brief Pain Inventory (CBPI)
C. Liverpool Osteoarthritis in Dogs (LOAD)
D. Helsinki Chronic Pain Index (HCPI)
E. Bologna Healing Stifle Injury Index (BHSII)

Answer: Canine Brief Pain Inventory (CBPI)

Explanation: CBPI’s factor analysis yielded inconsistent structures across studies, questioning construct stability.
In Radke 2022 et al., on outcome measure validation, what feature contributed to recommending CBPI, COI, and LOAD for clinical use?

A. Each tool demonstrated high criterion validity
B. Each tool had clearly defined ceiling and floor effects
C. Each showed sufficient content validity and (when applicable) internal consistency
D. All three were validated in surgical-only populations
E. They were endorsed by the AVMA

Answer: Each showed sufficient content validity and (when applicable) internal consistency

Explanation: These tools met COSMIN Category A criteria for recommendation based on their measurement properties.
In Radke 2022 et al., on outcome measure validation, which of the following OROMs demonstrated the **most rigorous development process** according to COSMIN criteria?

A. Canine Brief Pain Inventory (CBPI)
B. Canine Orthopedic Index (COI)
C. Liverpool Osteoarthritis in Dogs (LOAD)
D. Helsinki Chronic Pain Index (HCPI)
E. Hudson Visual Analogue Scale (HVAS)

Answer: Canine Orthopedic Index (COI)

Explanation: COI was rated as “adequate” for overall development, the highest rating among the instruments evaluated.
In Radke 2022 et al., on outcome measure validation, what was the COSMIN justification for not assessing internal consistency in the LOAD instrument?

A. The sample size was too small for analysis
B. LOAD showed poor reliability metrics
C. LOAD is based on a formative model rather than a reflective one
D. LOAD lacked construct validity
E. There were discrepancies in scoring methods

Answer: LOAD is based on a formative model rather than a reflective one

Explanation: Formative models do not require internal consistency analysis since items are not necessarily correlated.

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